Provider Demographics
NPI:1073408530
Name:MCCARTHY, ALECIA DIANE (RN)
Entity type:Individual
Prefix:MRS
First Name:ALECIA
Middle Name:DIANE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 E RENO ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-9380
Mailing Address - Country:US
Mailing Address - Phone:918-453-3619
Mailing Address - Fax:
Practice Address - Street 1:1924 S UTICA AVE STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6510
Practice Address - Country:US
Practice Address - Phone:918-973-4796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0078191163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management