Individual
MS. AURELIA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3364 BEYER BLVD, SAN YSIDRO, CA 92173-1322
(619) 205-4585
Mailing address
1650 ANDERSON MILL RD, APARTMENT #1208, AUSTELL, GA 30106-1252
(404) 964-3145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4440
SC
363L00000X
Nurse Practitioner
Primary
95024684
CA
363LF0000X
Family Nurse Practitioner
RN121276
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2048
—
SC
01
—
P01088998
RAILROAD MEDICARE
SC
Enumeration date
11/10/2005
Last updated
04/22/2024
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