Provider Demographics
NPI:1932307311
Name:MCALLISTER, REBECCA ANN (DNP, FNP-BC, APNP)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:DNP, FNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:WI
Mailing Address - Zip Code:53156-9312
Mailing Address - Country:US
Mailing Address - Phone:262-320-7820
Mailing Address - Fax:262-217-9399
Practice Address - Street 1:125 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:WI
Practice Address - Zip Code:53156
Practice Address - Country:US
Practice Address - Phone:262-320-7820
Practice Address - Fax:262-217-9399
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009911363LF0000X
VT101-0031988363LF0000X
IL209004120363LF0000X
WI5636-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQ12328Medicare UPIN