Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3016547 | KY |
NPI | 1023773132 |
---|---|
Provider Name | Mrs. Kristian Renee Allen |
First Address | Campton, KY 41301-7899 |
Second Address | Campton, KY 41301-7899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2021 |
Last Update Date | 03/11/2021 |