Healthcare Provider Details

I. General information

NPI: 1316077829
Provider Name (Legal Business Name): NANCY ANN CHILDRESS-MURPHY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY MURPHY D.O.

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 STATE HWY 66 SUITE F
CATOOSA OK
74015
US

IV. Provider business mailing address

14536 E 550 RD
INOLA OK
74036-5301
US

V. Phone/Fax

Practice location:
  • Phone: 918-739-4885
  • Fax: 918-739-4886
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4542
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: