Individual
TAMMY LOUISE ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 WHITE EAGLE DRIVE, PONCA CITY, OK 74601
(580) 765-2501
(580) 765-0984
Mailing address
200 WHITE EAGLE DRIVE, PONCA CITY, OK 74601
(580) 765-2501
(580) 765-0984
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0057845
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700590D
—
OK
05
—
200614060B
—
KS
Enumeration date
08/04/2010
Last updated
08/04/2010
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