Provider Demographics
NPI:1750935813
Name:ALLEN, ARETHA (CNA)
Entity type:Individual
Prefix:
First Name:ARETHA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 OATES DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3737
Mailing Address - Country:US
Mailing Address - Phone:919-610-3375
Mailing Address - Fax:
Practice Address - Street 1:3626 OATES DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-3737
Practice Address - Country:US
Practice Address - Phone:919-610-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-27
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40215376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide