Doctor Name: | MRS. TONYA RENEA ALLEN |
NPI Number: | 1013255298 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, NP-C |
License Number: | A003803 |
Business Practice Address: | 3112 S 70th St Fort Smith, AR - 729035068 |
Business Phone Number: | 4794528600 |
Business Fax Number: | |
Mailing Address: | 4815 W Markham St, LITTLE ROCK |
State: | AR |
Postal Code: | 722053866 |
Phone Number: | 5016612000 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2013 |
NPI Last Update Date: | 07/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A003803 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |