Individual
ELIZABETH CLARK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
728 CLINTON PKWY STE B, CLINTON, MS 39056-5227
(601) 200-4800
(601) 200-4805
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871440
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08287001
—
MS
01
—
P01198568
RAILROAD MEDICARE
MS
Enumeration date
02/18/2010
Last updated
09/15/2021
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