MEDICARE: RALETTA ALLEN

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
1	372600000X	Adult Companion		NE

General Provider Information

NPI Number	:	1437047487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RALETTA ALLEN

Provider Business Mailing Address
First Line	:	3105 S 15TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68108-2004
Country	:	US
Telephone Number	:	531-210-7022
Fax Number	:

Provider Business Practice Location Address
First Line	:	10005 CROWN POINT PLZ
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-1336
Country	:	US
Telephone Number	:	402-880-8001
Fax Number	:	402-880-8001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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Directions to “ RALETTA ALLEN ” Practice Location

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