Provider Demographics
NPI:1952163040
Name:ALLEN, KEISHA (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:KEISHA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 MASONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2115
Mailing Address - Country:US
Mailing Address - Phone:615-405-9535
Mailing Address - Fax:
Practice Address - Street 1:607 W DUE WEST AVE STE 97
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4420
Practice Address - Country:US
Practice Address - Phone:615-873-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMT0000033083146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic