Healthcare Provider Details

I. General information

NPI: 1013653849
Provider Name (Legal Business Name): ELIZABETH ALLEN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

4452 MACARTHUR BLVD NW UNIT 1/2
WASHINGTON DC
20007-2516
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8595
  • Fax: 202-444-1923
Mailing address:
  • Phone: 703-338-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP1059210
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: