Individual provider · NPI-1

Ellyn Allen, PA-C

Physician Assistant · Indianapolis, IN

NPI number1508637489
StatusActive
Last updated in NPPESMar 27, 2024

Details

NPI
1508637489
Entity type
Individual (NPI-1)
Name
Ellyn Allen
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Jan 10, 2024
Certification date
Mar 27, 2024
Last updated
Mar 27, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant10004323AINYes
2086S0129X NAIN

Practice location

5255 E Stop 11 Rd Ste 200
Indianapolis, IN 46237-6341

Phone 317-528-1212

Mailing address

Po Box 781076
Detroit, MI 48278-1076

Phone 317-528-4800

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