Provider Demographics
NPI:1922206382
Name:DALRYMPLE, SUE ELLA
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:ELLA
Last Name:DALRYMPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23315 E 830 RD
Mailing Address - Street 2:
Mailing Address - City:WELLING
Mailing Address - State:OK
Mailing Address - Zip Code:74471
Mailing Address - Country:US
Mailing Address - Phone:918-458-0804
Mailing Address - Fax:
Practice Address - Street 1:23315 E 830 RD
Practice Address - Street 2:
Practice Address - City:WELLING
Practice Address - State:OK
Practice Address - Zip Code:74471
Practice Address - Country:US
Practice Address - Phone:918-458-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker