Individual provider · NPI-1

Wilfred M Allen, NP

Nurse Practitioner · Detroit, MI

NPI number1306036397
StatusActive
Last updated in NPPESFeb 10, 2021

Details

NPI
1306036397
Entity type
Individual (NPI-1)
Name
Wilfred M Allen
Credential
NP
Sex
Male
Sole proprietor
No
Enumeration date
Jul 26, 2007
Certification date
Feb 10, 2021
Last updated
Feb 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner4704143956MIYes

Practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone 313-622-1380

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608

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