| Doctor Name: | DR. RENETTA WALTERS ALLEN |
| NPI Number: | 1366427460 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | APO4824 |
| Business Practice Address: | 11312 Jefferson Hwy River Ridge, LA - 701231709 |
| Business Phone Number: | 5044633002 |
| Business Fax Number: | |
| Mailing Address: | 3620 Lake Des Allemands Dr, HARVEY |
| State: | LA |
| Postal Code: | 700585163 |
| Phone Number: | 5049407348 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2005 |
| NPI Last Update Date: | 08/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APO4824 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |