Provider Demographics
NPI:1710225586
Name:ALLEN, TRAMANIA (LPN)
Entity Type:Individual
Prefix:MS
First Name:TRAMANIA
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 1:218 RENAISSANCE WAY
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-8006
Mailing Address - Country:US
Mailing Address - Phone:678-764-4585
Mailing Address - Fax:
Practice Address - Street 1:4196 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-3586
Practice Address - Country:US
Practice Address - Phone:678-342-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043089158164W00000X
GALPN085313164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse