MEDICARE: LAURA ALLEN NP

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	363L00000X	Nurse Practitioner	234290	MA

General Provider Information

NPI Number	:	1548342264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ALLEN NP

Provider Business Mailing Address
First Line	:	150 S HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4893
Country	:	US
Telephone Number	:	857-364-6772
Fax Number	:	857-364-6589

Provider Business Practice Location Address
First Line	:	150 S HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4893
Country	:	US
Telephone Number	:	857-364-6772
Fax Number	:	857-364-6589

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	06/25/2021

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Directions to “ LAURA ALLEN NP” Practice Location

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