Provider Demographics
NPI:1386819399
Name:MURPHY, KELLY REACE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:REACE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WFU BAPTIST HOSPITAL AUDIOLOGY
Mailing Address - Street 2:MEDICAL CENTER BLVD.
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-8189
Mailing Address - Fax:
Practice Address - Street 1:WFU BAPTIST HOSPITAL AUDIOLOGY
Practice Address - Street 2:MEDICAL CENTER BLVD.
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7583231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist