Provider Demographics
NPI:1205397205
Name:ALLEN, TERRY (NP)
Entity type:Individual
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First Name:TERRY
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:14555 LEVAN RD
Practice Address - Street 2:STE 311
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-655-2692
Practice Address - Fax:734-655-4218
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2025-07-18
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Provider Licenses
StateLicense IDTaxonomies
MI4704264054363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner