Provider Demographics
NPI:1053341354
Name:ALLEN, NANCY BELL (FNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:BELL
Last Name:ALLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 LOMBARDI CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-6793
Mailing Address - Country:US
Mailing Address - Phone:707-547-2266
Mailing Address - Fax:707-524-2473
Practice Address - Street 1:751 LOMBARDI CT
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-6793
Practice Address - Country:US
Practice Address - Phone:707-547-2266
Practice Address - Fax:707-524-2473
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily