Basic Information
| Provider Information | |||||||||
| NPI: | 1184626020 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLEN | ||||||||
| FirstName: | DELORIS | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8010 STAGE HILLS BLVD | ||||||||
| Address2: | |||||||||
| City: | BARTLETT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381334032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012912427 | ||||||||
| FaxNumber: | 9013790771 | ||||||||
| Practice Location | |||||||||
| Address1: | 3960 NEW COVINGTON PIKE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381282504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012912400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 10/15/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 62787 | TN | Y | Nursing Service Providers | Registered Nurse |
No ID Information.