Robert A Allen, RN
Individual provider Active NPI Registered Nurse · Beaver Dam, WI
NPI 1619682200 · NPPES record last updated Jan 18, 2023
Key facts
- NPI
- 1619682200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 197391-30 (WI)
- Practice address
- 215 Corporate Dr Ste D
Beaver Dam, WI 53916-3124 - Phone
- (920) 579-3808
- NPI assigned
- Jan 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197391-30 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 197391-30 | WI | Yes |
Addresses
Primary practice location
215 Corporate Dr Ste D
Beaver Dam, WI 53916-3124
Mailing address
215 Corporate Dr Ste D
Beaver Dam, WI 53916-3124
Phone (920) 356-9415
Other providers in Beaver Dam, WI
- Ahamed A Ahamed
- Rula Al-Baghdadi
- Kim Michelle Albridge
- Laeekha A Ali
- Bradley A Allen
- Dale R Alt
- Adam Altenburg
- Samantha Alvarado
- Ameripath Milwaukee SC
- Angels on Earth Home Care, LLC.
All providers in Beaver Dam, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.