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Individual

STEPHEN ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101646
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
NE
Enumeration date
06/25/2021
Last updated
08/02/2021
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