Provider Demographics
NPI:1386937258
Name:ALLEN, JENNIFER L (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:100 HOSPITAL LN
Practice Address - Street 2:SUITE 115
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1989
Practice Address - Country:US
Practice Address - Phone:317-718-4066
Practice Address - Fax:317-718-4076
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2021-03-02
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Provider Licenses
StateLicense IDTaxonomies
IN01074528A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201094740Medicaid
IN354590036Medicare PIN