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NPI Code Detail

MEDICARE: JOHN M ALLEN CRNA

MEDICARE: JOHN M ALLEN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse28180788AIN
2367500000XCertified Registered Nurse Anesthetist331810AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000600175OTHERINANTHEM PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376788042
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M ALLEN CRNA
Provider Business Mailing Address
First Line : 15343 W STATE ROAD 54
Second Line :
City : LINTON
State : IN
Zip : 47441-6226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4605 E ELWOOD ST STE 500
Second Line :
City : PHOENIX
State : AZ
Zip : 85040-1978
Country : US
Telephone Number : 602-200-9021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2008
Last Update Date : 04/28/2026

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Directions to “ JOHN M ALLEN CRNA” Practice Location

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