Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01083846A | IN |
Y | 208600000X | Surgeon | 01083846A | IN |
N | 208200000X | Surgeon | LL38246 | SC |
N | 208600000X | Surgeon | LL38246 | SC |
NPI | 1013397405 |
---|---|
Provider Name | Shelby Lynn Allen |
First Address | Greensboro, NC 27401-1449 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2015 |
Last Update Date | 23/07/2021 |