Provider Demographics
NPI:1568593432
Name:MURPHY, REBECCA ANNETTE
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANNETTE
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 1:480 S SOUTH SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45359
Mailing Address - Country:US
Mailing Address - Phone:937-408-0351
Mailing Address - Fax:
Practice Address - Street 1:480 S SOUTH SHILOH RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:OH
Practice Address - Zip Code:45359
Practice Address - Country:US
Practice Address - Phone:937-408-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2556309Medicaid