NPI Code Details Logo

NPI 1578564746

NPI 1578564746 : BRYAN E ALLEN RN, BSN-FNP : MIDLAND, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1578564746
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    BRYAN E ALLEN RN, BSN-FNP
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/09/2005
-----------------------------------------------------
    Last Update Date     |    04/04/2020
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4304 ANDREWS HWY 
-----------------------------------------------------
    City                 |    MIDLAND
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79703-4824
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    432-520-3020
-----------------------------------------------------
    Fax                  |    432-699-1981
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4304 ANDREWS HWY 
-----------------------------------------------------
    City                 |    MIDLAND
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79703-4824
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    432-520-3020
-----------------------------------------------------
    Fax                  |    432-699-1981
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    624626
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.