Provider Demographics
NPI:1497322838
Name:ALLEN, HOPE (PA)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SE 18TH ST
Mailing Address - Street 2:STE 1102
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5447
Mailing Address - Country:US
Mailing Address - Phone:352-512-0092
Mailing Address - Fax:352-512-0093
Practice Address - Street 1:5700 N ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2166
Practice Address - Country:US
Practice Address - Phone:719-543-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9115666363A00000X
COPA.0006917363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant