Provider Demographics
NPI:1821679838
Name:ALLEN, KYRA ELIZABETH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:ELIZABETH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 43RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2702
Mailing Address - Country:US
Mailing Address - Phone:347-848-2563
Mailing Address - Fax:
Practice Address - Street 1:3144 43RD ST APT 3
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2702
Practice Address - Country:US
Practice Address - Phone:347-848-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst