Basic Information
| Provider Information | |||||||||
| NPI: | 1154781144 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLEN | ||||||||
| FirstName: | ANDRIA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 418 CENTER ST | ||||||||
| Address2: | |||||||||
| City: | WHEELERSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456941712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407762785 | ||||||||
| FaxNumber: | 7407762793 | ||||||||
| Practice Location | |||||||||
| Address1: | 418 CENTER ST | ||||||||
| Address2: | |||||||||
| City: | WHEELERSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456941712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407762785 | ||||||||
| FaxNumber: | 7407762793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2016 | ||||||||
| LastUpdateDate: | 07/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.410831 | OH | Y | Nursing Service Providers | Registered Nurse | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.