Provider Demographics
NPI:1043286743
Name:ALLEN, JANE ESTHER (CPNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ESTHER
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ESTHER
Other - Last Name:ELLEFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:347 NORTH SMITH AVENUE
Mailing Address - Street 2:MAIL STOP #70-302, GARDEN VIEW MEDICAL BUILDING
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-220-5230
Mailing Address - Fax:651-220-5231
Practice Address - Street 1:347 NORTH SMITH AVENUE
Practice Address - Street 2:MAIL STOP #70-302, GARDEN VIEW MEDICAL BUILDING
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-220-5230
Practice Address - Fax:651-220-5231
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1084685163WP0200X
MN90033363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN233223000Medicare ID - Type Unspecified
500003227Medicare ID - Type Unspecified
Q57317Medicare UPIN