Provider Demographics
NPI:1275952558
Name:MCGILBRAY, PHYLLIS JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:JEAN
Last Name:MCGILBRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SW 174TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-9203
Mailing Address - Country:US
Mailing Address - Phone:405-863-3735
Mailing Address - Fax:405-217-2002
Practice Address - Street 1:121 SW 174TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-9203
Practice Address - Country:US
Practice Address - Phone:405-863-3735
Practice Address - Fax:405-217-2002
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0044272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse