Individual ProviderKenyetta F AllenLicensed Practical NurseNursing Service ProvidersPractice Address99 Waverly Ave, Apt 3-O, Patchogue, NY 11772-1900(631) 578-7885PECOS EnrollmentBased on the most recent information from CMS, provider Kenyetta F Allen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1699002360Provider TypeIndividualFull NameAllen, Kenyetta FTitleMs.CredentialLPNGenderFemaleSole ProprietorYesEnumeration Date11/17/2009Last Updated11/17/2009Contact InformationPractice LocationPractice Address99 Waverly Ave, Apt 3-O, Patchogue, NY 11772-1900Phone(631) 578-7885FaxUnlisted FaxMailing LocationMailing Address99 Waverly Ave, Apt 3-O, Patchogue, NY 11772-1900Phone(631) 578-7885FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense10 299109New York