Provider Demographics
NPI:1639522873
Name:MCALLISTER, MANDY J (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:J
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:J
Other - Last Name:BRUMMELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:6500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6890
Mailing Address - Country:US
Mailing Address - Phone:573-629-3491
Mailing Address - Fax:573-629-3429
Practice Address - Street 1:6500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6890
Practice Address - Country:US
Practice Address - Phone:573-629-3491
Practice Address - Fax:573-629-3429
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277003896363LF0000X
MO2025014834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily