Provider Demographics
NPI:1407884869
Name:ALLEN, DANA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PRINCETON RD STE 1
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-2040
Mailing Address - Country:US
Mailing Address - Phone:423-283-9913
Mailing Address - Fax:423-283-9908
Practice Address - Street 1:403 PRINCETON RD STE 1
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2040
Practice Address - Country:US
Practice Address - Phone:423-283-9913
Practice Address - Fax:423-283-9908
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006312363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4076224OtherBCBS
TN3723766Medicaid
TN3723766Medicaid
TN3723766Medicaid