1598849259 NPI number — DR. JENNIFER FINGER ALLEN DC

Table of content: GENNA CROSSIN (NPI 1649814047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598849259 NPI number — DR. JENNIFER FINGER ALLEN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
JENNIFER
Provider Middle Name:
FINGER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FINGER
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598849259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 KINGSLEY LAKE DR
Provider Second Line Business Mailing Address:
#603
Provider Business Mailing Address City Name:
SAINT AUGUSTINE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32092-3042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-342-4242
Provider Business Mailing Address Fax Number:
904-342-4243

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 KINGSLEY LAKE DR
Provider Second Line Business Practice Location Address:
#603
Provider Business Practice Location Address City Name:
SAINT AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32092-3042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-342-4242
Provider Business Practice Location Address Fax Number:
904-342-4243
Provider Enumeration Date:
10/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH9400 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 382233800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64331 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".