Deborah Jean Allen

Individual provider Active NPI Licensed Practical Nurse · Kennett, MO

NPI 1962062182 · NPPES record last updated Jun 19, 2019

Key facts

NPI
1962062182
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
2001014441 (MO)
Practice address
875 State Route VV
Kennett, MO 63857-9108
Phone
(573) 888-5925
NPI assigned
Jun 19, 2019
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
2001014441MOMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2001014441 MO Yes

Addresses

Primary practice location

875 State Route VV
Kennett, MO 63857-9108

Mailing address

875 State Route VV
Kennett, MO 63857-9108
Phone (573) 888-5925

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.