Healthcare Provider Details

I. General information

NPI: 1720190010
Provider Name (Legal Business Name): MONICA LYNN ALLEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E MAIN ST
DANVILLE IL
61832-5100
US

IV. Provider business mailing address

508 FANCY ST
COVINGTON IN
47932-1439
US

V. Phone/Fax

Practice location:
  • Phone: 217-554-4504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number28099930
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209006469
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: