Provider Demographics
NPI:1497866891
Name:ALLEN, MICHELLE ANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 SW PLASS CT
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1925
Mailing Address - Country:US
Mailing Address - Phone:785-233-7138
Mailing Address - Fax:785-233-7089
Practice Address - Street 1:2914 SW PLASS CT
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1925
Practice Address - Country:US
Practice Address - Phone:785-233-7138
Practice Address - Fax:785-233-7089
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45245363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100403270CMedicaid
KS160883OtherBLUE CROSS/BS
KSP41027Medicare UPIN