Provider Demographics
NPI:1740849090
Name:ALLEN, COURTNEY DANIELLE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DANIELLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 FRANKFORD RD APT 514
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-5307
Mailing Address - Country:US
Mailing Address - Phone:214-601-2114
Mailing Address - Fax:
Practice Address - Street 1:4849 FRANKFORD RD APT 514
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-5307
Practice Address - Country:US
Practice Address - Phone:214-601-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide