Healthcare Provider Details

I. General information

NPI: 1699700328
Provider Name (Legal Business Name): CHERI KAY ALLISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N ORANGE ST
BUTLER MO
64730-9382
US

IV. Provider business mailing address

1003 S ALLISON RD
EL DORADO SPRINGS MO
64744-2428
US

V. Phone/Fax

Practice location:
  • Phone: 660-890-8186
  • Fax:
Mailing address:
  • Phone: 417-876-6674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN128419
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: