Provider Demographics
NPI:1093238834
Name:ALLEN, PATRICIA NADINE (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NADINE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3870 PEACHTREE INDUSTRIAL BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1474
Mailing Address - Country:US
Mailing Address - Phone:678-665-2046
Mailing Address - Fax:470-567-5644
Practice Address - Street 1:8735 DUNWOODY PL # R
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2995
Practice Address - Country:US
Practice Address - Phone:678-665-2046
Practice Address - Fax:470-567-5644
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA669353363LF0000X
CANP95004212363LP2300X
GARN296746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care