Provider Demographics
NPI:1093971392
Name:ALLEN, SHARON THERESA (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:THERESA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SPRING VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3319
Mailing Address - Country:US
Mailing Address - Phone:845-831-9013
Mailing Address - Fax:845-473-6692
Practice Address - Street 1:56 SPRING VALLEY ST
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3319
Practice Address - Country:US
Practice Address - Phone:845-831-9013
Practice Address - Fax:845-473-6692
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100305-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse