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Individual

DESMA DENISE ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
498 NW 18TH ST # 416, RICHMOND, IN 47374-2851
(765) 373-8704
(765) 488-2609
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28163806A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004619A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300026936
IN
Enumeration date
07/09/2013
Last updated
06/26/2020
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