Provider Demographics
NPI:1467439141
Name:ALLEN, JACQUELINE DARDEN (NP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:DARDEN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:ELILLION
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:144 PINE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4454
Mailing Address - Country:US
Mailing Address - Phone:302-270-6447
Mailing Address - Fax:
Practice Address - Street 1:144 PINE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4454
Practice Address - Country:US
Practice Address - Phone:302-270-6447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH- 0000197363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health