Provider Demographics
NPI:1831743285
Name:ALLEN, ALBANY (CNA)
Entity type:Individual
Prefix:MRS
First Name:ALBANY
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 1:2320 E NORTH ST STE OFFICE10
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1247
Mailing Address - Country:US
Mailing Address - Phone:864-236-8007
Mailing Address - Fax:864-236-8006
Practice Address - Street 1:2320 E NORTH ST STE OFFICE10
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1247
Practice Address - Country:US
Practice Address - Phone:864-236-8007
Practice Address - Fax:864-236-8006
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0971251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health