Provider Demographics
NPI:1578155412
Name:CHARLES, ALLISON MICHELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MICHELLE
Last Name:CHARLES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:330 S 5TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5861
Mailing Address - Country:US
Mailing Address - Phone:877-247-7868
Mailing Address - Fax:405-342-0922
Practice Address - Street 1:330 S 5TH ST STE 206
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5861
Practice Address - Country:US
Practice Address - Phone:877-247-7868
Practice Address - Fax:405-342-0922
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK200858363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care