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Individual
TAMARA L ALLEN
Active
Individual
TAMARA L ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71011022A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001536550
ANTHEM PTAN
IN
01
—
1102440811
ANTHEM PTAN
IN
05
—
300049203
—
IN
Enumeration date
04/07/2021
Last updated
05/07/2025
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