Provider Demographics
NPI:1801681267
Name:MCALLISTER, MARY AGNES
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:AGNES
Last Name:MCALLISTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 ASH AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-2065
Mailing Address - Country:US
Mailing Address - Phone:575-649-4200
Mailing Address - Fax:
Practice Address - Street 1:1819 ASH AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2065
Practice Address - Country:US
Practice Address - Phone:575-649-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty