| Doctor Name: | MARIE EVANS ALLEN |
| NPI Number: | 1174803829 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | R863363 |
| Business Practice Address: | 2045 Highway 61 N Port Gibson, MS - 391504262 |
| Business Phone Number: | 6014373050 |
| Business Fax Number: | 6014373011 |
| Mailing Address: | 2045 Highway 61 N, PORT GIBSON |
| State: | MS |
| Postal Code: | 391504262 |
| Phone Number: | 6014373050 |
| Fax Number: | 6014373011 |
| NPI Enumeration Date: | 08/25/2011 |
| NPI Last Update Date: | 12/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R863363 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |