Provider Demographics
NPI:1922677384
Name:EAGLETON, ALISON JANE (APRN-CNS)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JANE
Last Name:EAGLETON
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5748 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-2713
Mailing Address - Country:US
Mailing Address - Phone:918-850-0478
Mailing Address - Fax:
Practice Address - Street 1:5748 E 62ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-2713
Practice Address - Country:US
Practice Address - Phone:918-850-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0046327364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative