Nurse Practitioner, Family
LISTA DALLIS
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1104468610 · enumerated 2019-10-16 · record updated 2022-02-17. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 1500 E DOWNING ST STE 214, TAHLEQUAH, OK, 74464-3379 (918) 413-0202 Fax (918) 431-0203 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 751, HULBERT, OK, 74441-0751 (187) 723-3990 Fax (918) 772-3638 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner, Family 363LF0000X · Primary · License 99753 OK
In this directory
Locations and evidence
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Practice location
TAHLEQUAH, OK, 744643379
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.