Provider Demographics
NPI:1992137343
Name:ALLEN, VIVIAN DENISE
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:DENISE
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 1:6707 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1254
Mailing Address - Country:US
Mailing Address - Phone:513-300-2582
Mailing Address - Fax:
Practice Address - Street 1:6707 PLANTATION WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1254
Practice Address - Country:US
Practice Address - Phone:513-300-2582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376029271196376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide