Provider Demographics
NPI:1114943396
Name:ALLEN, LAURA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:DEVLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:9500 E IRONWOOD SQUARE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-948-8400
Mailing Address - Fax:480-948-8401
Practice Address - Street 1:9500 E IRONWOOD SQUARE DR STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-948-8400
Practice Address - Fax:480-948-8401
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1348363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113905Medicare PIN