Basic Information
| Provider Information | |||||||||
| NPI: | 1972122745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCALLISTER | ||||||||
| FirstName: | BECKY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 HERITAGE CIR | ||||||||
| Address2: | |||||||||
| City: | PAWNEE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740583744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187622517 | ||||||||
| FaxNumber: | 9187626786 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 HERITAGE CIR | ||||||||
| Address2: | |||||||||
| City: | PAWNEE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740583744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187622517 | ||||||||
| FaxNumber: | 9187626786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2020 | ||||||||
| LastUpdateDate: | 04/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | 99868 | OK | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.