Individual
MS. MYRA BETH ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4800 48TH ST, VALLEY, AL 36854-3666
(334) 756-9180
Mailing address
3215 CUSSETA RD, LANETT, AL 36863-3882
(706) 773-5627
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-065136
AL
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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