| NPI | 1275272254 |
|---|---|
| Former Name | MACKENNA MARIE ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP026093) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA Pursuing) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2023-06-07 |