MARYSUE ELIZABETH FARRIS (NPI# 1073967246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073967246 |
| Entity Type | Individual |
| Full Name | MARYSUE ELIZABETH FARRIS |
| Other Name | MARYSUE ELIZABETH SLACK |
| Credential | APRN |
| Practice Address |
2900 S Telephone Rd Suite 250 Moore OK 73160-2968 |
| Mailing Address |
35737 Hamilton Rd Wanette OK 74878-6025 |
| Practice Telephone | 4052377500 |
| Mailing Telephone | 4058086160 |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2017-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WA2000X |
Registered Nurse Specialization: Administrator |
R0050272 | OK | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 50272 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F0816002 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | AANP CERTIFICATION | F0816002 | 01 |
| OK | RN LICENSE | R0050272 | 01 |
| Street Address |
2900 S TELEPHONE RD SUITE 250 |
| City | MOORE |
| State | OK |
| Zip Code | 73160-2968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942218755 | Rebecca R Wellington | Physician Assistant | 2900 S Telephone Rd, Ste. 250, Moore, OK 73160-2968 | 2006-08-04 |
| 1851869283 | Brittney Jolene Roberts | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2018-11-03 |
| 1588014724 | Renee Short | Nurse Practitioner | 2900 S Telephone Rd, Ste 250, Moore, OK 73160-2968 | 2016-06-19 |
| 1437512266 | Daniel Joshua Traum | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2016-03-30 |
| 1851750277 | Jolene Traum | Nurse Practitioner | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2016-02-12 |
| 1487044541 | Marissa Buckner | Nurse Practitioner | 2900 S Telephone Rd, Suite 250, Moore, OK 73160-2968 | 2015-01-28 |
| 1508268442 | Kasey Cory Green | Nurse Practitioner | 2900 S Telephone Rd, Suite 250, Moore, OK 73160-2968 | 2014-09-23 |
| 1093116170 | Jennifer Ann Barber | Nurse Practitioner | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2014-09-09 |
| 1043620388 | Nusrat Rumana | Family Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2014-05-07 |
| 1912332099 | Elizabeth Anne Magann | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2013-09-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730642455 | Amy Musick | Nurse Practitioner | 1317 Brice Dr, Moore, OK 73160-0744 | 2019-04-09 |
| 1043248701 | Jeffery David Barlow | Nurse Practitioner | 601 S Service Rd # 6253, Moore, OK 73160-5420 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457968695 | Christi Howell | Nurse Practitioner | 2304 Burning Tree, Norman, OK 73071-3919 | 2020-09-30 |
| 1093322240 | Lacey Campbell | Nurse Practitioner | 6124 Beverly Hills Dr, Edmond, OK 73034-8690 | 2020-09-30 |
| 1700403037 | Molly Lewis | Nurse Practitioner | 9001 S 101st East Ave Ste 230, Tulsa, OK 74133-5797 | 2020-07-02 |
| 1407471402 | Brenda June Wilson | Nurse Practitioner | 8609 Sw 58th Cir, Oklahoma City, OK 73179-7910 | 2020-06-15 |
| 1972139558 | Sammi Noel Pulliam | Nurse Practitioner | 700 W 7th Ave Ste 104, Bristow, OK 74010-2302 | 2020-03-16 |
| 1760017321 | Jennyfer Lynn Livingston | Nurse Practitioner | 105 S Bryant Ave # 205, Edmond, OK 73034-6399 | 2020-03-04 |
| 1336772771 | Lisa M Johnson | Nurse Practitioner | 3500 E Frank Phillips Blvd Ste 501, Bartlesville, OK 74006-2411 | 2020-02-13 |
| 1770123655 | Jennifer Katherine Yeaman | Nurse Practitioner | 4905 Nw 155th St, Edmond, OK 73013-9666 | 2020-01-08 |
| 1912546144 | Michelle Johnson | Nurse Practitioner | 1825 Preakness Path, Guthrie, OK 73044-7880 | 2020-01-06 |
| 1265071922 | Kristi Michelle Cooksey | Nurse Practitioner | 4713 Marston Ct, Norman, OK 73072-3116 | 2019-12-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.