| NPI | 1760772321 |
|---|---|
| Former Name | JUSTIN MICHAEL ALLEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 207265) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 202204598NP-PP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61379785) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NV 853522) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 356085) | |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2025-05-05 |