Healthcare Provider Details

I. General information

NPI: 1306278767
Provider Name (Legal Business Name): ALLISON LEE TAYLOR APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON LEE PITEZEL RN

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3361
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-6720
  • Fax: 918-502-6725
Mailing address:
  • Phone: 918-488-6045
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number92796
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: