Provider Demographics
NPI:1699199018
Name:ALLEN, MICHELLE MARIE (ARNP-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:COLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6782
Mailing Address - Country:US
Mailing Address - Phone:850-890-8518
Mailing Address - Fax:
Practice Address - Street 1:774 GA HWY 96
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005
Practice Address - Country:US
Practice Address - Phone:478-988-5711
Practice Address - Fax:478-988-5712
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9283895363LF0000X
GARN184598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily