Healthcare Provider Details

I. General information

NPI: 1154287779
Provider Name (Legal Business Name): ALLISON NICHOLE SIMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 E FRANK PHILLIPS BLVD
BARTLESVILLE OK
74006-2411
US

IV. Provider business mailing address

303 W MAIN ST
TYRO KS
67364-4825
US

V. Phone/Fax

Practice location:
  • Phone: 918-338-3730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number226644
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number226644
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: