Individual
AUDRA MICHELLE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 MARTHAS LOOP, CUSSETA, GA 31805-3820
(762) 233-3055
Mailing address
102 MARTHAS LOOP, CUSSETA, GA 31805-3820
(762) 233-3055
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2200596
GA
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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