Healthcare Provider Details

I. General information

NPI: 1760633416
Provider Name (Legal Business Name): ALLEN MICHAEL KAYE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NICOLLET AVE
MINNEAPOLIS MN
55403-3791
US

IV. Provider business mailing address

1801 NICOLLET AVE
MINNEAPOLIS MN
55403-3791
US

V. Phone/Fax

Practice location:
  • Phone: 612-596-0900
  • Fax: 612-879-3822
Mailing address:
  • Phone: 612-596-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR1184378
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: