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NPI Code Detail

MEDICARE: LYNETTE DAWN ALLEN LVN

MEDICARE: LYNETTE DAWN ALLEN LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse232507TX

General Provider Information

NPI Number : 1376955708
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNETTE DAWN ALLEN LVN
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-472-4357
Fax Number : 512-703-1394
Provider Business Practice Location Address
First Line : 403 E 15TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78701-1437
Country : US
Telephone Number : 512-445-7799
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 05/20/2014

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