Provider Demographics
NPI:1295177293
Name:ALLEN, LEORA MICHELLE (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:LEORA
Middle Name:MICHELLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6121 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4803
Mailing Address - Country:US
Mailing Address - Phone:301-770-8377
Mailing Address - Fax:301-816-7716
Practice Address - Street 1:6121 MONTROSE RD UNIT 206
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4803
Practice Address - Country:US
Practice Address - Phone:301-770-8377
Practice Address - Fax:301-816-7716
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1043287363LA2200X
VA0024179747363LA2200X
MDAC006212363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health