Healthcare Provider Details

I. General information

NPI: 1912822347
Provider Name (Legal Business Name): JONNA M ALLEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 SKYVIEW DR
MT STERLING KY
40353-1496
US

IV. Provider business mailing address

148 SKYVIEW DR
MT STERLING KY
40353-1496
US

V. Phone/Fax

Practice location:
  • Phone: 859-499-0717
  • Fax: 859-499-0926
Mailing address:
  • Phone: 859-499-0717
  • Fax: 859-499-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1125913
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4063578
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: