Individual
MR. ALLEN E STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, FNP
Contact information
Practice address
5130 HWY 95, FORT MOHAVE, AZ 86426
(928) 768-2811
(928) 768-9787
Mailing address
5130 HWY 95, FORT MOHAVE, AZ 86426
(928) 768-2811
(928) 768-9787
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AP11653
AZ
363L00000X
Nurse Practitioner
AP11653
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7353
ARIZONA LICENSE NUMER
AZ
01
—
AP11653
NURSE PRACTITIONER
AZ
Enumeration date
06/27/2006
Last updated
04/19/2024
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