Provider Demographics
NPI:1194212167
Name:MURPHY, TAMISHA LAKEISHA
Entity Type:Individual
Prefix:
First Name:TAMISHA
Middle Name:LAKEISHA
Last Name:MURPHY
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 1:2536 QUANTICO AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7009
Mailing Address - Country:US
Mailing Address - Phone:443-414-1686
Mailing Address - Fax:
Practice Address - Street 1:2536 QUANTICO AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7009
Practice Address - Country:US
Practice Address - Phone:443-414-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide