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NPI Code Detail

MEDICARE: TISA ALLEN LPN

MEDICARE:   TISA  ALLEN  LPN
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
1164W00000XLicensed Practical NursePN267228PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821733593
Entity Type Code : Individual
Provider Name (Legal Business Name) : TISA ALLEN LPN
Provider Business Mailing Address
First Line : 2999 PHILADELPHIA PIKE
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-2507
Country : US
Telephone Number : 302-792-0700
Fax Number : 302-792-0800
Provider Business Practice Location Address
First Line : 2999 PHILADELPHIA PIKE
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-2507
Country : US
Telephone Number : 302-792-0700
Fax Number : 302-792-0800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2022
Last Update Date : 04/28/2022

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Directions to “ TISA ALLEN LPN” Practice Location

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