Individual
MRS. ELVIA REA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 W. WHITE MOUNTAIN BLVD., SUITE D, LAKESIDE, AZ 85929-7014
(928) 368-4547
(928) 368-4527
Mailing address
300 W. WHITE MOUNTAIN BLVD., SUITE D, LAKESIDE, AZ 85929-7014
(928) 368-4547
(928) 368-4527
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0089702
OK
364SF0001X
Family Health Clinical Nurse Specialist
Primary
AP11398
AZ
Other
Enumeration date
10/25/2016
Last updated
08/06/2020
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