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NPI Code Detail

MEDICARE: ELLEN ELIZABETH ALLEN FNP

MEDICARE:   ELLEN ELIZABETH ALLEN  FNP
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
1363L00000XNurse PractitionerSP029032PA
2363LF0000XFamily Nurse Practitioner331880NC

General Provider Information

NPI Number : 1457059271
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN ELIZABETH ALLEN FNP
Provider Business Mailing Address
First Line : 195 PAGE MILL RD STE 103
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-2073
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 195 PAGE MILL RD STE 103
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-2073
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2023
Last Update Date : 01/28/2026

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