Provider Demographics
NPI:1730280686
Name:MCALISTER, DIANA LYNN (SA RN APN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:SA RN APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD STE 1
Mailing Address - Street 2:SUITE 700
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5337
Mailing Address - Country:US
Mailing Address - Phone:972-596-6676
Mailing Address - Fax:972-596-7078
Practice Address - Street 1:4708 ALLIANCE BLVD STE 1
Practice Address - Street 2:SUITE 700
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5337
Practice Address - Country:US
Practice Address - Phone:972-596-6676
Practice Address - Fax:972-596-7078
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX454184163WR0006X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210816903Medicaid
TX210816904Medicaid
TX210816904Medicaid
TXTXB114484Medicare PIN