Basic Information
Provider Information
NPI: 1518449065
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCALLISTER
FirstName: SARA
MiddleName: DANIELLE
NamePrefix: MRS.
NameSuffix:  
Credential: WHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 801143
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641801143
CountryCode: US
TelephoneNumber: 5733315583
FaxNumber: 5733315079
Practice Location
Address1: 211 SAINT FRANCIS DR
Address2:  
City: CAPE GIRARDEAU
State: MO
PostalCode: 637035049
CountryCode: US
TelephoneNumber: 5733391166
FaxNumber: 5733397166
Other Information
ProviderEnumerationDate: 08/31/2018
LastUpdateDate: 03/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X2018014164MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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