Healthcare Provider Details

I. General information

NPI: 1285969378
Provider Name (Legal Business Name): CARLETTA LYNN ALLEN CNA/CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 FRANKFORT RD APT. 112
SHELBYVILLE KY
40065-8446
US

IV. Provider business mailing address

80 FRANKFORT RD APT 112
SHELBYVILLE KY
40065-8447
US

V. Phone/Fax

Practice location:
  • Phone: 502-232-0432
  • Fax:
Mailing address:
  • Phone: 502-232-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: