Individual
KEISHA L ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9879 KENTUCKY ROUTE 122, MCDOWELL, KY 41647-6042
(606) 377-3427
(606) 377-3369
Mailing address
9879 KY ROUTE 122, MC DOWELL, KY 41647-6026
(606) 377-3427
(606) 377-3369
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1744
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100267780
—
KY
Enumeration date
09/11/2012
Last updated
11/15/2016
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