Provider Demographics
NPI:1972342186
Name:ALLEN, TAYLOR TAMARA (RN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:TAMARA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 SHEFFIELD LN # A
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3727
Mailing Address - Country:US
Mailing Address - Phone:267-438-9690
Mailing Address - Fax:
Practice Address - Street 1:1502 SHEFFIELD LN # A
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3727
Practice Address - Country:US
Practice Address - Phone:267-438-9690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA715990163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse