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General NPI Number Information
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NPI Number | 1669842498
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Entity Type | Individual
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Provider Name | ASHLEY R ALLEN APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 500 W FORT ST
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City | BOISE
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State | ID
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Zip | 83702-4599
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Country | US
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Telephone | 208-391-0787
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Fax | 208-502-2570
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Provider Business Mailing Address
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Address Line | 12148 LUFTBURROW LN
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City | HUDSON
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State | FL
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Zip | 34669-5005
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Country | US
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Telephone | 580-478-9601
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Fax | 208-502-2570
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 103435
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 67008
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License Number State | ID
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