Individual
MARY A ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
9000 N MAIN ST, SUITE G-36, DAYTON, OH 45415-1180
(937) 293-1622
(937) 245-6308
Mailing address
6680 POE AVE, SUITE 200, DAYTON, OH 45414-2854
(937) 280-8366
(937) 280-8373
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
CAO10613NP
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.10613NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3147393
—
OH
Enumeration date
04/29/2010
Last updated
10/19/2016
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