Individual
THERESA DIANE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NNP-BC
Contact information
Practice address
1 CHILDRENS PL STE 5S15, SAINT LOUIS, MO 63110-1002
(314) 495-1236
Mailing address
1 CHILDRENS PL STE 5S15, SAINT LOUIS, MO 63110-1002
(314) 495-1236
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
ALL1-0440-9583
MO
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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