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Alisa Tarasova, FNP
Family Nurse Practitioner in Chickasha, Oklahoma
NPI 1043782634

Alisa Tarasova is a Family Nurse Practitioner based in Chickasha, OK and is specialized in Family. Alisa Tarasova practices in Chickasha, OK and has the professional credentials of FNP. The NPI Number for Alisa Tarasova is 1043782634 and holds a License No. R0120108 (Oklahoma).

The current practice location address for Alisa Tarasova is 304 S 29Th St, Chickasha, OK and can be reached out via phone at 058-968-0584 and via fax at 855-223-1999.

Location: 304 S 29Th St, Chickasha, OK, 73023-0929
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043782634
Provider Name
Alisa Tarasova
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
304 S 29Th St, Chickasha, OK, 73023-0929
Phone Number
058-968-0584
Fax Number
855-223-1999
Provider Enumeration Date
12/20/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14383187 01 OK CAQH
institution
Provider Business Practice Location Address Details
Address
304 S 29Th St
City
Chickasha
State
Oklahoma
Zip
73018-2501
Phone Number
058-968-0584
Fax Number
855-223-1999
person
Provider Business Mailing Address Details
Address
304 S 29Th St
City
Chickasha
State
Oklahoma
Zip
73018-2501
Phone Number
058-968-0584
Fax Number
855-223-1999
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
R0120108 (Oklahoma)
Definition
Definition to come...
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