Provider Demographics
NPI:1518686484
Name:MURPHY, PAYTON NICOLE
Entity Type:Individual
Prefix:
First Name:PAYTON
Middle Name:NICOLE
Last Name:MURPHY
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 1:429 N MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-3637
Mailing Address - Country:US
Mailing Address - Phone:618-843-1084
Mailing Address - Fax:
Practice Address - Street 1:429 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-3637
Practice Address - Country:US
Practice Address - Phone:618-843-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency