Provider Demographics
NPI:1659702991
Name:ALLEN, DEENAH (RN PC)
Entity Type:Individual
Prefix:MS
First Name:DEENAH
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 MILLRACE LN APT 104
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7441 MILLRACE LN APT 104
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-2379
Practice Address - Country:US
Practice Address - Phone:216-374-0976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2019-06-10
Deactivation Date:2015-10-09
Deactivation Code:
Reactivation Date:2019-06-10
Provider Licenses
StateLicense IDTaxonomies
OHC.0900093101YP2500X
OHRN.385298163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional