Shari Lavida Allen, FNP – Family Nurse Practitioner

Key facts

NPI: 1679620967
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 200050018NP (OR)
Practice address: 115 SW Pine Street
Canyonville, OR 97417-0198
Phone: (541) 839-4211
Fax: (541) 839-4858
NPI assigned: Jan 5, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Falk Family Medicine, LLC Family Medicine Physician · Canyonville, OR · NPI 1255521225

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
200050018NP	OR	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Falk Family Medicine, LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	200050018NP	OR	Yes

Addresses

Primary practice location

115 SW Pine Street
Canyonville, OR 97417-0198

Mailing address

PO Box 198
PO Box 748
Canyonville, OR 97417-0198
Phone (541) 839-4211

Other identifiers

Identifier	Type	State	Issuer
268782	Medicaid	OR

Other providers in Canyonville, OR

All providers in Canyonville, OR · Family Nurse Practitioner in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2012. 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.

Verify at the official NPI Registry.