Basic Information
Provider Information
NPI: 1235457938
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: ALLISON
MiddleName: LINDSEY
NamePrefix: MRS.
NameSuffix:  
Credential: APRN-CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GOREE
OtherFirstName: ALLISON
OtherMiddleName: LINDSEY
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: APRN-CNP
OtherLastNameType: 1
Mailing Information
Address1: 608 LIBERTY LN
Address2:  
City: EDMOND
State: OK
PostalCode: 730349432
CountryCode: US
TelephoneNumber: 4053418829
FaxNumber: 4053418806
Practice Location
Address1: 608 LIBERTY LN
Address2:  
City: EDMOND
State: OK
PostalCode: 730349432
CountryCode: US
TelephoneNumber: 4053418829
FaxNumber: 4053418806
Other Information
ProviderEnumerationDate: 05/06/2010
LastUpdateDate: 12/26/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X83423OKY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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