Healthcare Provider Details

I. General information

NPI: 1235054255
Provider Name (Legal Business Name): ALLISON JOHNSON APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 E BLUE STARR DR
CLAREMORE OK
74017-4223
US

IV. Provider business mailing address

206 E BLUE STARR DR
CLAREMORE OK
74017-4223
US

V. Phone/Fax

Practice location:
  • Phone: 918-341-8100
  • Fax:
Mailing address:
  • Phone: 918-341-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number203767
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: