Stella Michelle Allen

Individual provider Active NPI Licensed Practical Nurse · Kennett, MO

NPI 1225857055 · NPPES record last updated Oct 8, 2024

Key facts

NPI
1225857055
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
2009025672 (MO)
Practice address
1226 Independence Ave
Kennett, MO 63857-1316
Phone
(573) 559-2380
NPI assigned
Oct 8, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2009025672MOMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2009025672 MO Yes

Addresses

Primary practice location

1226 Independence Ave
Kennett, MO 63857-1316

Mailing address

1226 Independence Ave
Kennett, MO 63857-1316
Phone (573) 559-2380

Other providers in Kennett, MO

All providers in Kennett, MO · Licensed Practical Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.