Provider Demographics
NPI:1033241310
Name:MURPHY, TIERNEY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIERNEY
Middle Name:ANNE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 S SAINT FRANCIS DR
Mailing Address - Street 2:RUNNELS BUILDING, N1305
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-6110
Mailing Address - Country:US
Mailing Address - Phone:505-827-6816
Mailing Address - Fax:
Practice Address - Street 1:1190 S SAINT FRANCIS DR
Practice Address - Street 2:RUNNELS BUILDING, N1305
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87502-6110
Practice Address - Country:US
Practice Address - Phone:505-827-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F20857Medicare UPIN