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General NPI Number Information
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NPI Number | 1285283143
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Entity Type | Individual
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Provider Name | KIMBERLY N ALLYN BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 1940 NE 55TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-3151
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Country | US
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Telephone | 954-684-3682
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Fax |
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Provider Business Mailing Address
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Address Line | 2841 NE 33RD CT APT 402
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-2042
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Country | US
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Telephone | 954-684-3682
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9267299
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License Number State | FL
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