Provider Demographics
NPI:1265109938
Name:ALLEN, DARYL (LM)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 SELMAN CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-6079
Mailing Address - Country:US
Mailing Address - Phone:575-302-1771
Mailing Address - Fax:
Practice Address - Street 1:3910 SELMAN CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-6079
Practice Address - Country:US
Practice Address - Phone:575-302-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM21004R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife