Provider Demographics
NPI:1396542700
Name:ALLEN, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:DEAN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:819 BOX BUTTE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2939
Mailing Address - Country:US
Mailing Address - Phone:308-760-2298
Mailing Address - Fax:
Practice Address - Street 1:819 BOX BUTTE AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-2939
Practice Address - Country:US
Practice Address - Phone:308-760-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion