Provider Demographics
NPI:1619979010
Name:MURPHY, PAMELA L (CRNA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:NE
Mailing Address - Zip Code:69140-0209
Mailing Address - Country:US
Mailing Address - Phone:308-352-2319
Mailing Address - Fax:
Practice Address - Street 1:900 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:GRANT
Practice Address - State:NE
Practice Address - Zip Code:69140-3095
Practice Address - Country:US
Practice Address - Phone:308-352-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101129367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered