Provider Demographics
NPI:1760935548
Name:MURPHY, JENA MICHELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:MICHELLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4900 BROAD ROAD POB SOUTH 2G
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-2408
Mailing Address - Country:US
Mailing Address - Phone:315-299-5313
Mailing Address - Fax:315-299-5661
Practice Address - Street 1:3107 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1646
Practice Address - Country:US
Practice Address - Phone:315-299-5313
Practice Address - Fax:315-299-5661
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily