Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | D35284 | MD |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | E9016 | AR |
NPI | 1598727273 |
---|---|
Provider Name | Andrea Mckinna Allen |
First Address | North Little Rock, AR 72116-7086 |
Second Address | North Little Rock, AR 72116-7086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
477431100 | (05) | MD |
D74553 | (02) |