Provider Demographics
NPI:1710122387
Name:MURGA, KELLEE STEELE (CNS)
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:STEELE
Last Name:MURGA
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:KELLEE
Other - Middle Name:ANN
Other - Last Name:STABLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:3201 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-8801
Mailing Address - Country:US
Mailing Address - Phone:541-281-9948
Mailing Address - Fax:
Practice Address - Street 1:3201 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-8801
Practice Address - Country:US
Practice Address - Phone:541-885-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201394037364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200934760Medicaid