Tarasova, Alisa

Tarasova, Alisa is an individual health care provider with primary practice located at 304 S 29Th St , Chickasha OK 73018-2501. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tarasova, Alisa can be contacted via phone (058) 968-0584.

Contact Information

Primary practice address
304 S 29Th St Chickasha OK 73018-2501
Phone: (058) 968-0584
Fax: (855) 223-1999
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R0120108 Oklahoma

Profile Details

NPI number 1043782634
LBN Legal business name Tarasova, Alisa
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2018
Last updated Nov 21st, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043782634 NPPES
Oklahoma Other 14383187 CAQH

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