Provider Demographics
NPI:1659701837
Name:ALLEN, RUTH LANORA (RN)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:LANORA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 BRECKRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-5305
Mailing Address - Country:US
Mailing Address - Phone:866-877-2762
Mailing Address - Fax:866-992-7144
Practice Address - Street 1:700 S PARKER DR STE 7
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6059
Practice Address - Country:US
Practice Address - Phone:866-877-2762
Practice Address - Fax:866-992-7144
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC73067163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse