Charles Allen, Nurse practitioner
Clinic/Center, Ambulatory Surgical in Kansas City, MO. Individual provider (NPI-1).
NPI number1275285751
StatusActive
Last updated in NPPESDec 21, 2023
Details
- NPI
- 1275285751
- Entity type
- Individual (NPI-1)
- Name
- Mr. Charles Allen
- Credential
- Nurse practitioner
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 25, 2022
- Certification date
- Dec 21, 2023
- Last updated
- Dec 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | 1427617729 | GA | Yes |
| 133VN1201X | Dietitian, Registered, Nutrition, Obesity and Weight Management | 134659711 | MO | |
| 174V00000X | Clinical Ethicist | 1427617729 | GA |
Practice location
2321 Troost Ave Ste 101Kansas City, MO 64108-2834
Phone 816-200-2409 · Fax 816-320-0028
Mailing address
Po Box 18361Kansas City, MO 64133-8361
Phone 816-200-2409 · Fax 816-320-0028
Other practice locations
417 Sw Ward Rd
Lees Summit, MO 64081-2448
Lees Summit, MO 64081-2448
Phone 816-200-2409 · Fax 816-320-0028
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