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NPI Code Detail

MEDICARE: MORGAN MAYBERRY

MEDICARE: MORGAN MAYBERRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR0132078OK

General Provider Information

NPI Number : 1104781442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN MAYBERRY
Provider Business Mailing Address
First Line : 6839 S CANTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-3402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6161 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1902
Country : US
Telephone Number : 918-494-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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Directions to “ MORGAN MAYBERRY ” Practice Location

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