Provider Demographics
NPI:1043514854
Name:ALLEN, CAROLYN MICHELLE (CRNP-F)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CRNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 KING ARTHUR WAY
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-8905
Mailing Address - Country:US
Mailing Address - Phone:301-464-7614
Mailing Address - Fax:
Practice Address - Street 1:5802 KING ARTHUR WAY
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-8905
Practice Address - Country:US
Practice Address - Phone:301-464-7614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-08
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR133461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily