Healthcare Provider Details

I. General information

NPI: 1457794604
Provider Name (Legal Business Name): VALERIE GAYLE ALLEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HOSPITAL WAY
SOMERSET KY
42503-2872
US

IV. Provider business mailing address

3624 VAUGHT RIDGE RD
BETHELRIDGE KY
42516-6738
US

V. Phone/Fax

Practice location:
  • Phone: 606-451-2600
  • Fax:
Mailing address:
  • Phone: 606-219-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3007977
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: