Provider Demographics
NPI:1528438223
Name:MURDOCK, DOROTHY (FNP-C)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DOTTI
Other - Middle Name:A
Other - Last Name:MURDOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3011 N MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2546
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:620-231-5062
Practice Address - Street 1:801 W 8TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-4109
Practice Address - Country:US
Practice Address - Phone:620-251-4300
Practice Address - Fax:620-251-4979
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK92678363LF0000X
KS77922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily