Provider Demographics
NPI:1699480798
Name:ALLEN, VETRICE
Entity type:Individual
Prefix:
First Name:VETRICE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5322 NW 20TH WAY APT B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-2180
Mailing Address - Country:US
Mailing Address - Phone:352-575-4602
Mailing Address - Fax:
Practice Address - Street 1:5322 NW 20TH WAY
Practice Address - Street 2:APTB
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653
Practice Address - Country:US
Practice Address - Phone:352-575-4602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty