Individual provider · Type 1 NPI

Lista Marie Dallis

Family Nurse Practitioner · Tahlequah, OK

NPI number 1104468610 Active

Practice location

1500 E Downing St Ste 214
Tahlequah, OK 74464-3379

Fax (918) 431-0203

Mailing address

PO Box 751
Hulbert, OK 74441-0751

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X99753 (OK)

Family Nurse Practitioner: Definition to come...

7 other providers at this address

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About NPI 1104468610

Lista Marie Dallis's National Provider Identifier is 1104468610, issued on Oct 16, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Tahlequah, OK. The record was last updated on Feb 17, 2022.