Individual
MARY JANE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, BC
Contact information
Practice address
3150 LENOX PARK BLVD, SUITE 214, MEMPHIS, TN 38115-4299
(901) 273-2368
(901) 273-2351
Mailing address
3150 LENOX PARK BLVD, SUITE 214, MEMPHIS, TN 38115-4299
(901) 273-2368
(901) 273-2351
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN0000006880
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3928988
—
TN
05
—
3928989
—
TN
01
—
4148068
BCBS OF TENNESSEE
TN
01
—
P00365538
RAILROAD MEDICARE
TN
Enumeration date
01/17/2006
Last updated
10/29/2009
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