Provider Demographics
NPI:1619094943
Name:ALLEN, BARBARA J (ARNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14430 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3237
Mailing Address - Country:US
Mailing Address - Phone:772-581-8003
Mailing Address - Fax:772-581-8005
Practice Address - Street 1:14430 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3237
Practice Address - Country:US
Practice Address - Phone:772-581-8003
Practice Address - Fax:772-581-8005
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9178578363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY09K8OtherBLUE CROSS AND BLUE SHIELD
FL004326000Medicaid
FL004326000Medicaid