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Individual

KELLY ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
514 W 3RD AVE, WARREN, PA 16365-2201
(814) 723-2219
(814) 723-9127
Mailing address
26244 SOUTH RD, SPARTANSBURG, PA 16434-2448
(814) 723-5545
(814) 723-9127

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP013345
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP013345
CRNP
PA
Enumeration date
11/19/2013
Last updated
12/05/2019
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