Provider Demographics
NPI:1316377955
Name:MULRYAN, PHILIPPA MORGAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:PHILIPPA
Middle Name:MORGAN
Last Name:MULRYAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1588 E VENTNOR AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1250
Mailing Address - Country:US
Mailing Address - Phone:801-671-6507
Mailing Address - Fax:
Practice Address - Street 1:1588 E VENTNOR AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1250
Practice Address - Country:US
Practice Address - Phone:801-671-6507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT270157-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist