Healthcare Provider Details

I. General information

NPI: 1649191396
Provider Name (Legal Business Name): KIMBERLY RAE ALLEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 POLK ST STE A
TWIN FALLS ID
83301-3916
US

IV. Provider business mailing address

3708 N 2710 E
TWIN FALLS ID
83301-0160
US

V. Phone/Fax

Practice location:
  • Phone: 208-814-7375
  • Fax: 208-814-7376
Mailing address:
  • Phone: 208-316-5855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7381120
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: