Provider Demographics
NPI:1558746826
Name:MURPHY, LISA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 N MO PAC EXPY STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3055
Mailing Address - Country:US
Mailing Address - Phone:512-482-0045
Mailing Address - Fax:737-200-7303
Practice Address - Street 1:7000 N MO PAC EXPY STE 420
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3055
Practice Address - Country:US
Practice Address - Phone:512-482-0045
Practice Address - Fax:737-200-7303
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3549263-03Medicaid