Healthcare Provider Details

I. General information

NPI: 1932964004
Provider Name (Legal Business Name): RAYANNE MARIE ALLEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 BELL BEND RD
BERWICK PA
18603-6816
US

IV. Provider business mailing address

118 BELL BEND RD
BERWICK PA
18603-6816
US

V. Phone/Fax

Practice location:
  • Phone: 570-417-6130
  • Fax:
Mailing address:
  • Phone: 570-417-6130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN517574-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: