Provider Demographics
NPI:1356602700
Name:ALLRED, ERIN S (APRN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:S
Last Name:ALLRED
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEA
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 GORDON COOPER DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-8603
Mailing Address - Country:US
Mailing Address - Phone:405-878-7160
Mailing Address - Fax:405-878-7149
Practice Address - Street 1:1900 GORDON COOPER DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-8603
Practice Address - Country:US
Practice Address - Phone:405-878-7160
Practice Address - Fax:405-878-7149
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK92737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily