Provider Demographics
NPI:1023885860
Name:ALLEN MIND BODY & SPIRIT HEALTH, PLLC
Entity type:Organization
Organization Name:ALLEN MIND BODY & SPIRIT HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHNP
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP AND MHNP
Authorized Official - Phone:765-585-3725
Mailing Address - Street 1:508 FANCY ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47932-1439
Mailing Address - Country:US
Mailing Address - Phone:765-585-3725
Mailing Address - Fax:
Practice Address - Street 1:735 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4369
Practice Address - Country:US
Practice Address - Phone:765-585-3725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty