Provider Demographics
NPI:1306365390
Name:MURPHY, JON GERARD (FNP, EDD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:GERARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:FNP, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MERRITT COLLEGE STUDENT HEALTH SERVICES R-106
Mailing Address - Street 2:12500 CAMPUS DRIVE
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619
Mailing Address - Country:US
Mailing Address - Phone:510-436-2533
Mailing Address - Fax:510-434-3865
Practice Address - Street 1:MERRITT COLLEGE STUDENT HEALTH SERVICES
Practice Address - Street 2:12500 CAMPUS DRIVE
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619
Practice Address - Country:US
Practice Address - Phone:510-436-2533
Practice Address - Fax:510-434-3864
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457877163W00000X
CA8622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse