Healthcare Provider Details

I. General information

NPI: 1649424755
Provider Name (Legal Business Name): ROSEITTA M MURRIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 SE 54TH ST
OKLAHOMA CITY OK
73135-1444
US

IV. Provider business mailing address

3212 SE 54TH ST
OKLAHOMA CITY OK
73135-1444
US

V. Phone/Fax

Practice location:
  • Phone: 405-305-5997
  • Fax:
Mailing address:
  • Phone: 405-305-5997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: