Provider Demographics
NPI:1407732704
Name:ALLEN, CLAUDETTE (RN)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:X
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 RIVER COVE CT
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-2099
Mailing Address - Country:US
Mailing Address - Phone:901-648-1440
Mailing Address - Fax:
Practice Address - Street 1:1201 W PEACHTREE ST NW STE 2300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3453
Practice Address - Country:US
Practice Address - Phone:404-793-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000221032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse