MEDICARE: KRISTINE K MURROW PA

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
1	363AM0700X	Medical Physician Assistant	1016	OK

General Provider Information

NPI Number	:	1679760243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE K MURROW PA

Provider Business Mailing Address
First Line	:	3613 NW 56TH ST
Second Line	:	SUITE 140
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4526
Country	:	US
Telephone Number	:	405-942-3600
Fax Number	:	405-942-3939

Provider Business Practice Location Address
First Line	:	3613 NW 56TH ST
Second Line	:	SUITE 140
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4526
Country	:	US
Telephone Number	:	405-942-3600
Fax Number	:	405-942-3939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2007
Last Update Date	:	11/09/2007

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