| Doctor Name: | MRS. JENNIFER EMMA ALLRED |
| NPI Number: | 1124078407 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 908 |
| Business Practice Address: | 1900 Woodland Dr Coos Bay, OR - 974202045 |
| Business Phone Number: | 5412675151 |
| Business Fax Number: | 5412664527 |
| Mailing Address: | 1900 Woodland Dr, COOS BAY |
| State: | OR |
| Postal Code: | 974202045 |
| Phone Number: | 5412675151 |
| Fax Number: | 5412664527 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 01/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 908 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |