Healthcare Provider Details

I. General information

NPI: 1942517925
Provider Name (Legal Business Name): CYNTHIA J ALLEN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2010
Last Update Date: 09/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 W ROYALE DR
MUNCIE IN
47304-2264
US

IV. Provider business mailing address

1910 W ROYALE DR
MUNCIE IN
47304-2264
US

V. Phone/Fax

Practice location:
  • Phone: 765-289-1011
  • Fax: 765-289-3024
Mailing address:
  • Phone: 765-289-1011
  • Fax: 765-289-3024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28066716A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: