Individual
MRS. JUANITA NICOLE GOLDEN-ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 875-3000
Mailing address
437 E 78TH LN, MERRILLVILLE, IN 46410-5612
(219) 306-9633
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
1059740
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1059740
TX
363LA2100X
Acute Care Nurse Practitioner
2021029675
MO
363LA2100X
Acute Care Nurse Practitioner
28217110A
IN
363LA2100X
Acute Care Nurse Practitioner
71007958A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420100120
—
MO
Enumeration date
04/17/2018
Last updated
10/15/2024
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