MEDICARE: MRS. CHENA YVONNE 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
1	363LF0000X	Family Nurse Practitioner	F02250353	GA

General Provider Information

NPI Number	:	1700687274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHENA YVONNE ALLEN FNP

Provider Business Mailing Address
First Line	:	950 EAGLES LANDING PKWY # 746
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-7343
Country	:	US
Telephone Number	:	404-939-0522
Fax Number	:

Provider Business Practice Location Address
First Line	:	2056 DONALD LEE HOLLOWELL PKWY NW STE 1
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-4764
Country	:	US
Telephone Number	:	470-890-3910
Fax Number	:

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

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	05/06/2026

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