Provider Demographics
NPI:1598517369
Name:ALLEN, AUDREY KATE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:KATE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 BELLA PL
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-1612
Mailing Address - Country:US
Mailing Address - Phone:817-991-6796
Mailing Address - Fax:
Practice Address - Street 1:5000 BRIARWOOD AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2753
Practice Address - Country:US
Practice Address - Phone:432-682-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143028363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner