Provider Demographics
NPI:1619031846
Name:FLUKER, ALISHA (PMHNP-BC, WHCNP)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:FLUKER
Suffix:
Gender:F
Credentials:PMHNP-BC, WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1947
Mailing Address - Country:US
Mailing Address - Phone:469-770-7415
Mailing Address - Fax:
Practice Address - Street 1:9708 SKILLMAN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5150
Practice Address - Country:US
Practice Address - Phone:214-221-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670559363LW0102X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180670505Medicaid
TX180670506Medicaid
TX180670502Medicaid
TX180670508Medicaid
TX180670503Medicaid
TX180670507Medicaid
TX180670510Medicaid
TX180670504Medicaid
TX180670509Medicaid
TX180670511Medicaid
TX8Y5478OtherBLUE CROSS BLUE SHIELD