Provider Demographics
NPI:1265244065
Name:FLETCHER, ALISON NICOLE (LPN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 GRAND CASINO BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-1005
Mailing Address - Country:US
Mailing Address - Phone:405-964-5770
Mailing Address - Fax:405-964-5783
Practice Address - Street 1:8508 BRANGUS RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-6503
Practice Address - Country:US
Practice Address - Phone:405-915-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0071660164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse