Provider Demographics
NPI:1568845717
Name:MURPHY-CLARKE, ANGELIE
Entity Type:Individual
Prefix:
First Name:ANGELIE
Middle Name:
Last Name:MURPHY-CLARKE
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 1:12 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2948
Mailing Address - Country:US
Mailing Address - Phone:617-851-6836
Mailing Address - Fax:781-269-5765
Practice Address - Street 1:12 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2948
Practice Address - Country:US
Practice Address - Phone:617-851-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse