Audra Michelle Allen
Individual provider Active NPI Home Health Registered Nurse · Cusseta, GA
NPI 1962929802 · NPPES record last updated Aug 22, 2017
Key facts
- NPI
- 1962929802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 2200596 (GA)
- Practice address
- 102 Marthas Loop
Cusseta, GA 31805-3820 - Phone
- (762) 233-3055
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2200596 | GA | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 2200596 | GA | Yes |
Addresses
Primary practice location
102 Marthas Loop
Cusseta, GA 31805-3820
Mailing address
102 Marthas Loop
Cusseta, GA 31805-3820
Phone (762) 233-3055
Other providers in Cusseta, GA
- Mia Beveridge
- Jessica Roberson Brown
- Careconnect Health, Inc.
- Chattahoochee Board of Health
- Chattahoochee County School System
All providers in Cusseta, GA · Home Health Registered Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2017. 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.