Provider Demographics
NPI:1477739415
Name:ALLEN, PAIGE (RN)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S DITMAR ST
Mailing Address - Street 2:APT. 2A
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3168
Mailing Address - Country:US
Mailing Address - Phone:760-966-6853
Mailing Address - Fax:
Practice Address - Street 1:224 S DITMAR ST
Practice Address - Street 2:APT. 2A
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3168
Practice Address - Country:US
Practice Address - Phone:760-966-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA590488163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse