Provider Demographics
NPI:1720260508
Name:ALLSMAN, LORA LEE (NP)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:LEE
Last Name:ALLSMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:LEE
Other - Last Name:TUBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9108 W JAMESBURG ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5309
Mailing Address - Country:US
Mailing Address - Phone:909-725-5730
Mailing Address - Fax:
Practice Address - Street 1:1261 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4302
Practice Address - Country:US
Practice Address - Phone:316-773-2733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6151363L00000X
CA17614363LF0000X
KS53-77680-061363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily