Provider Demographics
NPI:1083051718
Name:ALLEN, ASHLEY (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1463
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-1463
Mailing Address - Country:US
Mailing Address - Phone:318-935-0434
Mailing Address - Fax:
Practice Address - Street 1:104 BAY HILLS DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-9452
Practice Address - Country:US
Practice Address - Phone:318-617-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN107122163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant