Provider Demographics
NPI:1457588188
Name:ALLEN, CARLINE A (RN)
Entity Type:Individual
Prefix:MS
First Name:CARLINE
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 BADGER RAVINE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8035
Mailing Address - Country:US
Mailing Address - Phone:702-485-4489
Mailing Address - Fax:
Practice Address - Street 1:4160 S PECOS RD
Practice Address - Street 2:STE 17
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5025
Practice Address - Country:US
Practice Address - Phone:702-433-5368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN58003163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health