Individual
MICHELLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
534 MAPLE VALLEY DR, FARMINGTON, MO 63640-1981
(573) 760-8253
Mailing address
PO BOX 957683, SAINT LOUIS, MO 63195-1981
(573) 756-6751
(573) 760-8044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2010013174
MO
363LF0000X
Family Nurse Practitioner
Primary
2010013174
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467639278
—
MO
01
—
204795132
TAX ID
—
05
—
428821904
—
MO
01
—
P00702570
RAILROAD MEDICARE
—
Enumeration date
01/23/2008
Last updated
09/26/2025
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