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General NPI Number Information
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NPI Number | 1265078570
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Entity Type | Individual
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Provider Name | PAULA NICOLE ALLEN
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Gender | Female
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 109 BARTON CREEK CT
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City | COLUMBIA
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State | SC
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Zip | 29229-8027
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Country | US
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Telephone | 803-356-2286
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Fax | 803-419-8430
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Provider Business Mailing Address
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Address Line | 133 BEAVER DAM RD
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City | COLUMBIA
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State | SC
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Zip | 29223-3101
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Country | US
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Telephone | 803-469-6990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 23396
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23396
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License Number State | SC
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