Healthcare Provider Details

I. General information

NPI: 1336035542
Provider Name (Legal Business Name): AUDREY MCMURRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 E 31ST ST
TULSA OK
74146-1908
US

IV. Provider business mailing address

PO BOX 740020
ATLANTA GA
30374-0020
US

V. Phone/Fax

Practice location:
  • Phone: 918-400-7002
  • Fax: 539-202-5130
Mailing address:
  • Phone: 918-400-7002
  • Fax: 539-202-5130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number225498
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: