Provider Demographics
NPI:1811004716
Name:MURPHY, JODEE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:JODEE
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JODEE
Other - Middle Name:ANN
Other - Last Name:HOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3000 N CHESTNUT ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-3054
Mailing Address - Country:US
Mailing Address - Phone:952-448-2050
Mailing Address - Fax:952-448-2185
Practice Address - Street 1:3000 N CHESTNUT ST
Practice Address - Street 2:SUITE 120
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-3054
Practice Address - Country:US
Practice Address - Phone:952-448-2050
Practice Address - Fax:952-448-2185
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24704Medicare UPIN