Individual
MRS. JACKIE L. ALLEN
Active
Individual
MRS. JACKIE L. ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
R069517
GA
163WP2201X
Ambulatory Care Registered Nurse
R069517
GA
363LA2200X
Adult Health Nurse Practitioner
R069517
GA
Other
Enumeration date
04/26/2006
Last updated
09/11/2025
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