Provider Demographics
NPI:1396596375
Name:ALLEN, BENJAMIN B (RN, BSN, CNOR, RNFA)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:B
Last Name:ALLEN
Suffix:
Gender:M
Credentials:RN, BSN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35456-1908
Mailing Address - Country:US
Mailing Address - Phone:205-792-4443
Mailing Address - Fax:
Practice Address - Street 1:1847 COMMONS NORTH DR
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3700
Practice Address - Country:US
Practice Address - Phone:205-349-0049
Practice Address - Fax:659-734-2003
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131521163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant