Provider Demographics
NPI:1902154503
Name:ALLEN, PATRICIA GROCHOWINA (MSN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GROCHOWINA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 POLO DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-4245
Mailing Address - Country:US
Mailing Address - Phone:267-218-5675
Mailing Address - Fax:
Practice Address - Street 1:221 POLO DR
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-4245
Practice Address - Country:US
Practice Address - Phone:267-218-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012297163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult