Provider Demographics
NPI:1285969378
Name:ALLEN, CARLETTA LYNN (CNA/CMT)
Entity type:Individual
Prefix:MISS
First Name:CARLETTA
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CNA/CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FRANKFORT RD APT 112
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8447
Mailing Address - Country:US
Mailing Address - Phone:502-232-0432
Mailing Address - Fax:
Practice Address - Street 1:80 FRANKFORT RD
Practice Address - Street 2:APT. 112
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8446
Practice Address - Country:US
Practice Address - Phone:502-232-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No172V00000XOther Service ProvidersCommunity Health Worker
No372600000XNursing Service Related ProvidersAdult Companion