Provider Demographics
NPI:1104127463
Name:ALLEN, BROOKE ELLEN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELLEN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:622 ENGLISHMAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-9346
Mailing Address - Country:US
Mailing Address - Phone:724-984-3904
Mailing Address - Fax:
Practice Address - Street 1:555 W NEWTON ST
Practice Address - Street 2:SUITE 10
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2861
Practice Address - Country:US
Practice Address - Phone:724-832-7045
Practice Address - Fax:724-832-9165
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011033363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics