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Individual

JACQUELINE D ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
210 BLACK GOLD BLVD, STE 106, HAZARD, KY 41701-2620
(606) 436-0711
(606) 435-1322
Mailing address
PO BOX 959, HAZARD, KY 41702-0959
(606) 436-0711
(606) 435-1322

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3009147
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3009147
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3009147
LICENSE
KY
Enumeration date
01/22/2015
Last updated
05/13/2021
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