Provider Demographics
NPI:1932351780
Name:ALLEN, DEBORAH L (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:KOWALICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 ARDEN LN STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2995
Mailing Address - Country:US
Mailing Address - Phone:803-980-7337
Mailing Address - Fax:
Practice Address - Street 1:342 PATRICIA LN STE 105
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6608
Practice Address - Country:US
Practice Address - Phone:803-431-7490
Practice Address - Fax:803-431-7491
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily