Healthcare Provider Details

I. General information

NPI: 1073921334
Provider Name (Legal Business Name): MS. HELEN M ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN M COATS

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S NATIONAL AVE
SPRINGFIELD MO
65807
US

IV. Provider business mailing address

PO BOX 4046
SPRINGFIELD MO
65808-4046
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-5158
  • Fax: 417-269-4265
Mailing address:
  • Phone: 417-269-5712
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2014021929
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: