Individual provider · NPI-1

Jeremy D Allen, FNP

Nurse Practitioner, Family · Columbus, GA

NPI number1124751110
StatusActive
Last updated in NPPESOct 31, 2023

Details

NPI
1124751110
Entity type
Individual (NPI-1)
Name
Mr. Jeremy D Allen
Credential
FNP
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 6, 2022
Certification date
Oct 25, 2023
Last updated
Oct 31, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyGAA-NP001339GAYes
363LF0000X Nurse Practitioner, Family1-137953AL

Practice location

3201 Macon Rd Ste 109
Columbus, GA 31906-1741

Phone 706-225-8773

Mailing address

9431 Lee Road 240
Phenix City, AL 36870-9211

Other practice locations

228 Selma Ave
Selma, AL 36701-5825

Phone 334-877-1490

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