Provider Demographics
NPI:1588299499
Name:MCFALLS, NATASHA D (APRN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:D
Last Name:MCFALLS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 NE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5807
Mailing Address - Country:US
Mailing Address - Phone:405-237-9955
Mailing Address - Fax:405-735-5136
Practice Address - Street 1:507 NE 12TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5807
Practice Address - Country:US
Practice Address - Phone:405-237-9955
Practice Address - Fax:405-735-5136
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK76254363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health