Healthcare Provider Details

I. General information

NPI: 1598375818
Provider Name (Legal Business Name): NISHANT ALLENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 LONE OAK RD
PADUCAH KY
42003-4526
US

IV. Provider business mailing address

160 OVERLOOK DRIVE
PADUCAH KY
42003
US

V. Phone/Fax

Practice location:
  • Phone: 270-442-3647
  • Fax:
Mailing address:
  • Phone: 929-451-3463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number61421
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: