Healthcare Provider Details

I. General information

NPI: 1275758427
Provider Name (Legal Business Name): JAMES M ALLEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOLIDAY BISON DR
MC COOK NE
69001-4416
US

IV. Provider business mailing address

PO BOX 788
MC COOK NE
69001-0788
US

V. Phone/Fax

Practice location:
  • Phone: 308-345-7036
  • Fax: 308-345-7039
Mailing address:
  • Phone: 308-345-7036
  • Fax: 308-345-7039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number772
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number772
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: