Provider Demographics
NPI:1417095019
Name:MURPHY, TAMMY L (CST, CFA)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CST, CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 FORGED WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-9215
Mailing Address - Country:US
Mailing Address - Phone:502-727-4448
Mailing Address - Fax:812-952-3415
Practice Address - Street 1:6527 FORGED WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-9215
Practice Address - Country:US
Practice Address - Phone:502-727-4448
Practice Address - Fax:812-952-3415
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSA125363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical