Provider Demographics
NPI:1457153330
Name:ALLEN, ANGELA LYNETTE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNETTE
Last Name:ALLEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BOONES DR
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-9639
Mailing Address - Country:US
Mailing Address - Phone:301-388-6853
Mailing Address - Fax:
Practice Address - Street 1:3800 W ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1320
Practice Address - Country:US
Practice Address - Phone:202-977-0352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant