Provider Demographics
NPI:1275834962
Name:ALLEN, TATIANA DANIELLE (BSN, RN)
Entity Type:Individual
Prefix:MS
First Name:TATIANA
Middle Name:DANIELLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 CLAY CT
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-9080
Mailing Address - Country:US
Mailing Address - Phone:330-749-4976
Mailing Address - Fax:
Practice Address - Street 1:1344 CLAY CT
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-9080
Practice Address - Country:US
Practice Address - Phone:330-749-4976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH354233163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice