Provider Demographics
NPI:1598370462
Name:ALLINDER, MALLORY J (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:J
Last Name:ALLINDER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17944 JASMINE CT
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-8750
Mailing Address - Country:US
Mailing Address - Phone:651-894-2371
Mailing Address - Fax:
Practice Address - Street 1:17944 JASMINE CT
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-8750
Practice Address - Country:US
Practice Address - Phone:651-894-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1964873163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care