Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | R7P15 | MO |
NPI | 1497738785 |
---|---|
Provider Name | Dr. Victoria L Allen |
First Address | Wildwood, MO 63011-1901 |
Second Address | Fenton, MO 63026-2124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 26/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0105047 | UNITED HEALTHCARE (01) | MO |
116943 | BLUE CROSS BLUE SHIELD (01) | MO |
205957 | HEALTHLINK (01) | MO |
431828874 | CHOICECARE NETWORK (01) | MO |
431828874 | GALAXY HEALTH NETWORK (01) | MO |
431828874 | GREAT WEST (01) | MO |
431828874 | MCS (01) | MO |
431828874 | NPPN (01) | MO |
431828874 | PHCS (01) | MO |
5538116 | AETNA (01) | MO |
E96534 | (02) | MO |
E96534 | MERCY HEALTH PLANS (01) | MO |