Provider Demographics
NPI:1558643148
Name:ALLEN, KARREL ANDREW
Entity Type:Individual
Prefix:
First Name:KARREL
Middle Name:ANDREW
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 WILLIAMSBURG RD N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-5137
Mailing Address - Country:US
Mailing Address - Phone:513-225-4351
Mailing Address - Fax:
Practice Address - Street 1:4112 WILLIAMSBURG RD N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-5137
Practice Address - Country:US
Practice Address - Phone:513-225-4351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTM763660376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker