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Individual

BONNIE M. ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1471 CHESTER BLVD, RICHMOND, IN 47374-1945
(765) 935-8581
(765) 935-1171
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8581
(765) 935-1171

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005645A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000957439
ANTHEM (REID PHYSICIAN ASSOCIATES, INC.)
05
0152309
OH
05
201313040
IN
Enumeration date
08/16/2015
Last updated
05/12/2021
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