Provider Demographics
NPI:1699332031
Name:MCALESTER, NICOLE LEEANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LEEANN
Last Name:MCALESTER
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 1:1313 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6303
Mailing Address - Country:US
Mailing Address - Phone:918-591-5700
Mailing Address - Fax:918-758-1944
Practice Address - Street 1:1400 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4288
Practice Address - Country:US
Practice Address - Phone:918-423-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK117294163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse