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Individual

DR. RENETTA WALTERS ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
11312 JEFFERSON HWY, RIVER RIDGE, LA 70123-1709
(504) 463-3002
Mailing address
3641 LAKE TIMBERLANE DR, GRETNA, LA 70056-8310
(504) 940-7348

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APO4824
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1453129
LA
Enumeration date
12/12/2005
Last updated
12/04/2018
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