Provider Demographics
NPI:1528255288
Name:ALLEN, KRISTEN LEE (RN, PNP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LEE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4522
Mailing Address - Country:US
Mailing Address - Phone:516-677-5437
Mailing Address - Fax:516-282-0999
Practice Address - Street 1:596 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4522
Practice Address - Country:US
Practice Address - Phone:516-677-5437
Practice Address - Fax:516-282-0999
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5770094363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics