Individual
FELICIA ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744P3200X
TRICARE , BLUE CROS BLUE SHIELDS, CIGNA DPPO
NC
01
—
335E00000X
PROSTHETIC/ORTHOTIC SUPPLIER
NC
Enumeration date
08/08/2022
Last updated
08/08/2022
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