Healthcare Provider Details

I. General information

NPI: 1215729454
Provider Name (Legal Business Name): ALLISON TAYLOR GLOVER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8921 S MINGO RD
TULSA OK
74133-5841
US

IV. Provider business mailing address

1408 S DELAWARE PL
TULSA OK
74104-4838
US

V. Phone/Fax

Practice location:
  • Phone: 918-252-8000
  • Fax:
Mailing address:
  • Phone: 405-760-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR0120082
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: