Provider Demographics
NPI:1104201706
Name:MURPHY, CAITLIN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 BLUE JAY CV
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1604
Mailing Address - Country:US
Mailing Address - Phone:314-922-0338
Mailing Address - Fax:
Practice Address - Street 1:1703 BLUE JAY CV
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1604
Practice Address - Country:US
Practice Address - Phone:314-922-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015025694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2015025694OtherPHARMACIST LICENSE