Healthcare Provider Details

I. General information

NPI: 1073431060
Provider Name (Legal Business Name): MADELINE ALLISON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 E EVERGREEN ST
SPRINGFIELD MO
65803-4300
US

IV. Provider business mailing address

PO BOX 9227
SPRINGFIELD MO
65801-9227
US

V. Phone/Fax

Practice location:
  • Phone: 417-823-2900
  • Fax: 417-823-2981
Mailing address:
  • Phone: 417-837-2041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026031813
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: