Provider Demographics
NPI:1740001973
Name:ALLISON, REBECCA MARY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARY
Last Name:ALLISON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 GOODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6208
Mailing Address - Country:US
Mailing Address - Phone:918-527-8940
Mailing Address - Fax:
Practice Address - Street 1:4414 LOVERS LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6923
Practice Address - Country:US
Practice Address - Phone:469-809-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily