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Individual

BAMBI IVEY ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
817 GRIFFIN AVE, EASTMAN, GA 31023-6718
(478) 374-1801
Mailing address
817 GRIFFIN AVE, EASTMAN, GA 31023-6718

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN190630
GA
363LF0000X
Family Nurse Practitioner
Primary
RN190630
GA

Other

Enumeration date
09/04/2019
Last updated
09/04/2019
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