Provider Demographics
NPI:1720208150
Name:ALLEN, LORA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:LYNN
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 1:15428 GROVE RD. SE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43837
Mailing Address - Country:US
Mailing Address - Phone:740-498-5742
Mailing Address - Fax:
Practice Address - Street 1:15428 GROVE RD. SE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43837
Practice Address - Country:US
Practice Address - Phone:740-498-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN313735163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse