Provider Demographics
NPI:1003430026
Name:ALLEN, SHARAN LYNN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:SHARAN
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4401 PARK SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-2016
Mailing Address - Country:US
Mailing Address - Phone:817-807-9060
Mailing Address - Fax:817-419-4505
Practice Address - Street 1:4401 PARK SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-2016
Practice Address - Country:US
Practice Address - Phone:817-807-9060
Practice Address - Fax:817-419-4505
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP146160363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health