Provider Demographics
NPI:1548619521
Name:MURPHY, KRISTIN RENEE (PMHNP-BC, LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RENEE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PMHNP-BC, LCSW
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:RENEE
Other - Last Name:RECTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4131 W LOOMIS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2057
Mailing Address - Country:US
Mailing Address - Phone:414-424-2445
Mailing Address - Fax:414-424-2446
Practice Address - Street 1:4131 W LOOMIS RD STE 120
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-2057
Practice Address - Country:US
Practice Address - Phone:414-424-2245
Practice Address - Fax:414-424-2446
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10644363LP0808X
WI8468-1231041C0700X
WI14113-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical