Provider Demographics
NPI:1699700328
Name:ALLISON, CHERI KAY (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:KAY
Last Name:ALLISON
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 1:1003 S ALLISON RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-2428
Mailing Address - Country:US
Mailing Address - Phone:417-876-6674
Mailing Address - Fax:
Practice Address - Street 1:805 N ORANGE ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-9382
Practice Address - Country:US
Practice Address - Phone:660-890-8186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN128419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOX93000052Medicare PIN
MOMA1521018Medicare PIN
MOP38899Medicare UPIN