Provider Demographics
NPI:1457984965
Name:ALLEN, AFTON MELISSA (PHARM D)
Entity Type:Individual
Prefix:
First Name:AFTON
Middle Name:MELISSA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 N 900 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2913
Mailing Address - Country:US
Mailing Address - Phone:801-706-7548
Mailing Address - Fax:
Practice Address - Street 1:555 S 200 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7249
Practice Address - Country:US
Practice Address - Phone:801-397-7833
Practice Address - Fax:801-397-7827
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5484188-17011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist