Provider Demographics
NPI:1568687564
Name:ALLEN, TERESA G (LPN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:G
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 LAWNSIDE RD
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-2804
Mailing Address - Country:US
Mailing Address - Phone:215-437-9746
Mailing Address - Fax:
Practice Address - Street 1:4254 LAWNSIDE RD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19154-2804
Practice Address - Country:US
Practice Address - Phone:215-437-9746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPNO80394L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse