Healthcare Provider Details

I. General information

NPI: 1710481932
Provider Name (Legal Business Name): NORA JANE ALLEN RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORA JANE AHERN RN

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WOODLAND RD
SAINT HELENA CA
94574-9554
US

IV. Provider business mailing address

4276 TULANE CT
FAIRFIELD CA
94534-9621
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-3611
  • Fax:
Mailing address:
  • Phone: 720-470-2776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberCNS4088
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: