MEDICARE: MR. STEPHEN MCALLISTER APRN-NP, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.357376	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0029225	OH

General Provider Information

NPI Number	:	1790133890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN MCALLISTER APRN-NP, PMHNP-BC

Provider Business Mailing Address
First Line	:	2321 TAYLOR PARK DR # 1109
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8052
Country	:	US
Telephone Number	:	614-595-2077
Fax Number	:	949-543-2708

Provider Business Practice Location Address
First Line	:	2321 TAYLOR PARK DR # 1109
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8052
Country	:	US
Telephone Number	:	614-595-2077
Fax Number	:	949-543-2708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	01/17/2025

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