Provider Demographics
NPI:1104221969
Name:MURPHY, DANIELLE DUTCHER (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DUTCHER
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W RALPH HALL PKWY STE 137
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6691
Mailing Address - Country:US
Mailing Address - Phone:214-369-3613
Mailing Address - Fax:972-772-3300
Practice Address - Street 1:1005 W RALPH HALL PKWY STE 137
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6691
Practice Address - Country:US
Practice Address - Phone:214-369-3613
Practice Address - Fax:972-772-3300
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2420363A00000X
TXPA13175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant