Doris Jean Petty, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R0027558 Issued in OK

Practice address

200 Wanda
Marietta, OK 73448

Phone

(580) 276-3323

Fax

(580) 276-3324

NPI assigned

Jun 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083811871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 4TH AVE NW TRLR 77",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012529",
            "telephone_number": "580-276-3323",
            "fax_number": "580-276-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WANDA",
            "city": "MARIETTA",
            "state": "OK",
            "postal_code": "73448",
            "telephone_number": "580-276-3323",
            "fax_number": "580-276-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "DORIS",
        "middle_name": "JEAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0027558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Health Love County Rural Health Clinic
• Susan Raelene Miller, R.N.
• Morning Star a.T.U.
• John Thomas O'Connor Jr., D.O.
• Patricia Owens, FNP
• Melinda Sue Pitts, R.N.
• Larry Dean Powell, M.D.
• Mariana Sanchez
• SCG Lake Country LLC (Lake Country Nursing Center)
• Charles Reid Schnorrenberg, RPH

• Registered Nurse in Marietta, OK
• Providers in Marietta, OK by specialty
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.