Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP146160 | TX |
NPI | 1003430026 |
---|---|
Provider Name | Miss Sharan Lynn Allen |
First Address | Grand Prairie, TX 75051-3796 |
Second Address | Grand Prairie, TX 75051-3796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2020 |
Last Update Date | 05/06/2020 |