Provider Demographics
NPI:1194551291
Name:ASBILL, ALLISON JANIECE (ARPN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JANIECE
Last Name:ASBILL
Suffix:
Gender:F
Credentials:ARPN
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JANIECE
Other - Last Name:HAYTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:CREDENTIALING OFC, GROUND FL
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-3023
Mailing Address - Country:US
Mailing Address - Phone:918-403-7065
Mailing Address - Fax:
Practice Address - Street 1:4720 S HARVARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3023
Practice Address - Country:US
Practice Address - Phone:918-749-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK220041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201306380AMedicaid