Provider Demographics
NPI:1003265901
Name:MULLER, LUCY (RN)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:
Last Name:MULLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LUCY
Other - Middle Name:JEAN
Other - Last Name:MULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2202 SW B AVE
Mailing Address - Street 2:APT 108
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-4113
Mailing Address - Country:US
Mailing Address - Phone:352-587-4104
Mailing Address - Fax:
Practice Address - Street 1:4301 WILSON ROAD
Practice Address - Street 2:
Practice Address - City:FT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-558-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK114520163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse