| NPI | 1356616924 |
|---|---|
| Former Name | JUANITA ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005548) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 17851) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2021-10-11 |