Provider Demographics
NPI:1063747426
Name:ALLEN, TONI LAVON (LPN)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:LAVON
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12920 PARKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3914
Mailing Address - Country:US
Mailing Address - Phone:813-234-9566
Mailing Address - Fax:
Practice Address - Street 1:12920 PARKINGTON DR
Practice Address - Street 2:
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-3914
Practice Address - Country:US
Practice Address - Phone:813-234-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5149992164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse