Active NPI
Gwendolyn Olivia Allen, CRNP
- Nurse Practitioner
- Birmingham, AL
National Provider Identifier
1275204794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1-063494
- Practice address
- 1713 6TH Avenue South
Birmingham, AL 35294-0018 - Phone
- (205) 975-4532
- Fax
- (205) 975-2969
- NPI assigned
- Sep 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-063494 | AL | Primary |
Addresses
Primary practice location
1713 6TH Avenue South
Birmingham, AL 35294-0018
Mailing address
PO Box 10672
Birmingham, AL 35202-0672
Phone (205) 532-6190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-063494 | AL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1275204794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10672",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352020672",
"telephone_number": "205-532-6190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 6TH AVENUE SOUTH",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352940018",
"telephone_number": "205-975-4532",
"fax_number": "205-975-2969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "GWENDOLYN",
"middle_name": "OLIVIA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-23",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-063494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.