Healthcare Provider Details

I. General information

NPI: 1962165548
Provider Name (Legal Business Name): ALLYSON ELAINE DINN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 S WASHINGTON ST
KOKOMO IN
46902-3513
US

IV. Provider business mailing address

2821 S WASHINGTON ST
KOKOMO IN
46902-3513
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-3173
  • Fax: 765-453-5628
Mailing address:
  • Phone: 765-453-3173
  • Fax: 765-453-5628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26029351A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: