Provider Demographics
NPI:1609579838
Name:ALLEN, INDIA (LPN)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
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 1:150 E ARLINGTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5019
Mailing Address - Country:US
Mailing Address - Phone:252-353-2555
Mailing Address - Fax:
Practice Address - Street 1:313 STEEPLECHASE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-9553
Practice Address - Country:US
Practice Address - Phone:252-721-8073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87448164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse