Provider Demographics
NPI:1356838080
Name:MURDOCK, KATHRYN M
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:MURDOCK
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 1:4966 STATE HIGHWAY 23 STE O
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-4504
Mailing Address - Country:US
Mailing Address - Phone:607-367-4571
Mailing Address - Fax:607-367-4574
Practice Address - Street 1:4966 STATE HIGHWAY 23 STE O
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-4504
Practice Address - Country:US
Practice Address - Phone:607-367-4571
Practice Address - Fax:607-367-4574
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY661879163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse