Provider Demographics
NPI:1003222928
Name:ALLEN, MAUREEN PATRICE MCGOFF (BSN-RN, MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:PATRICE MCGOFF
Last Name:ALLEN
Suffix:
Gender:F
Credentials:BSN-RN, MSN-FNP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:PATRICE
Other - Last Name:MCGOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6189 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1826
Mailing Address - Country:US
Mailing Address - Phone:317-517-1062
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-2744
Practice Address - Country:US
Practice Address - Phone:216-444-5329
Practice Address - Fax:216-445-1521
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004980A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily