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General NPI Number Information
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NPI Number | 1104278548
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Entity Type | Individual
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Provider Name | ALLISON DIANE HENRICHS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 315 W KANSAS
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City | OKARCHE
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State | OK
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Zip | 73762-9227
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Country | US
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Telephone | 405-263-4450
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Fax | 405-263-4440
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Provider Business Mailing Address
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Address Line | 315 W KANSAS
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City | OKARCHE
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State | OK
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Zip | 73762-9227
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Country | US
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Telephone | 405-263-4450
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Fax | 405-263-4440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 73681
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License Number State | OK
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