IndividualActive
Alyssa Wall
NPI 1255146486 · Licensed Practical Nurse · Shawnee, OK
Provider details
- NPI number
- 1255146486
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 209671 (OK)
Specialties & taxonomies
Nursing Service Providers
Practice location
781 Grand Casino Blvd
Shawnee, OK 74804-1005
Phone: (405) 964-5770
Approximate (ZIP-level) locationGet directions
Mailing address
781 Grand Casino Blvd
Shawnee, OK 74804-1005
Registry dates
- Enumerated
- 2025-02-13
- Last updated
- 2025-02-13
- Certified
- 2025-02-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.