Provider Demographics
NPI:1770902447
Name:ALLMAN, CONNIE ELAINE (FNP-C)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:ELAINE
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 HIGHWAY 411 N
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-5438
Mailing Address - Country:US
Mailing Address - Phone:423-263-6208
Mailing Address - Fax:423-263-6202
Practice Address - Street 1:2235 HIGHWAY 411 N
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-5438
Practice Address - Country:US
Practice Address - Phone:423-263-6208
Practice Address - Fax:423-263-6202
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000018626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily