person
Lista Marie Dallis
Family Nurse Practitioner in Tahlequah, Oklahoma
NPI 1104468610

Lista Marie Dallis is a Family Nurse Practitioner based in Hulbert, OK and is specialized in Family. Lista Marie Dallis practices in Tahlequah, OK. The NPI Number for Lista Marie Dallis is 1104468610 and holds a License No. 99753 (Oklahoma).

The current practice location address for Lista Marie Dallis is 1500 E Downing St Ste 214, Tahlequah, OK and can be reached out via phone at 918-413-0202 and via fax at 918-431-0203. You can also correspond with Lista Marie Dallis through the mailing address at PO BOX 751, HULBERT, OK - 74441-0751 (mailing address contact number: 187-723-3990).

Location: 1500 E Downing St Ste 214, Tahlequah, OK, 74441-0751
person
Provider Profile Details
NPI Number
1104468610
Provider Name
Lista Marie Dallis
Credential
Provider Entity Type
Individual
Gender
Female
Address
1500 E Downing St Ste 214, Tahlequah, OK, 74441-0751
Phone Number
918-413-0202
Fax Number
918-431-0203
Provider Enumeration Date
10/16/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1500 E Downing St Ste 214
City
State
Zip
74464-3379
Phone Number
918-413-0202
Fax Number
918-431-0203
person
Provider Business Mailing Address Details
Address
1500 E Downing St Ste 214
City
State
Zip
74464-3379
Phone Number
918-413-0202
Fax Number
918-431-0203
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
99753 (Oklahoma)
Definition
Definition to come...
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