Individual
KIM ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 681-4500
(318) 681-7402
Mailing address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 681-4500
(318) 681-7402
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP03711
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP03711
ADVANCED PRACTICE LIC
LA
Enumeration date
02/23/2007
Last updated
11/09/2009
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