Individual
MISTY C ALLEN
Active
Individual
MISTY C ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-047642
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051552673
—
AL
05
—
06234720
—
MS
01
—
430076327
PALMETTO GBA-RR MEDICARE
—
01
—
51511554
BCBS
AL
01
—
G4193
BLUE SHIELD
FL
Enumeration date
06/23/2006
Last updated
09/01/2010
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