Provider Demographics
NPI:1508262155
Name:MURPHY, JESSICA KAY (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KAY
Last Name:MURPHY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10057 ELISE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-4033
Mailing Address - Country:US
Mailing Address - Phone:314-808-2287
Mailing Address - Fax:
Practice Address - Street 1:1000 DES PERES RD
Practice Address - Street 2:SUITE 310
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-2050
Practice Address - Country:US
Practice Address - Phone:314-821-1313
Practice Address - Fax:314-821-5670
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014039716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily