Provider Demographics
NPI:1790983005
Name:MURPHY, MEREDITH GAYLE (LICAC)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:GAYLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 IVY LN
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2153
Mailing Address - Country:US
Mailing Address - Phone:610-265-1827
Mailing Address - Fax:
Practice Address - Street 1:144 IVY LN
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2153
Practice Address - Country:US
Practice Address - Phone:610-265-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO000516171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist