Individual
ELAINE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
391 S HERITAGE WAY, PENDLETON, IN 46064-9587
(765) 290-0763
(765) 393-3172
Mailing address
391 S HERITAGE WAY, PENDLETON, IN 46064-9587
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28167768A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71009657A
APRN PRESCRITPIVE AUTHORITY
IN
01
—
71009657B
CSR-PRESCRITPIVE AUTHORITY
IN
Enumeration date
01/03/2020
Last updated
01/27/2025
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