Provider Demographics
NPI:1811993603
Name:ALLEN, KAREN L (RN/CNM)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22602 N 42ND PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8720
Mailing Address - Country:US
Mailing Address - Phone:480-473-7180
Mailing Address - Fax:480-473-7180
Practice Address - Street 1:4212 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5319
Practice Address - Country:US
Practice Address - Phone:602-263-1200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN041111363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
61981284OtherFEDERAL CONTRACTOR TPIN