Provider Demographics
NPI:1790384717
Name:ALLEN, PATRICIA MARIE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-1511
Mailing Address - Country:US
Mailing Address - Phone:740-395-3393
Mailing Address - Fax:
Practice Address - Street 1:2505 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-1511
Practice Address - Country:US
Practice Address - Phone:740-395-3393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant