LISTA DALLIS

Family Nurse Practitioner

NPI: 1104468610IndividualAccepts Medicare

Specialties, Licenses & Credentials

Family Nurse PractitionerPrimary

Nurse Practitioner — Family

Code: 363LF0000X

99753(OK)

CMS Specialties

PrimaryNURSE PRACTITIONER

Education

OTHER

Class of 2019

Contact & Hours

Address: 1500 E DOWNING ST STE 214
TAHLEQUAH, OK 74464
Phone: (918) 413-0202

Quick Facts

NPI: 1104468610
Entity Type: Individual
Gender: Female
Medicare: Accepted
Specialties: 1
Locations: 1
Years in Practice: 7

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