Provider Demographics
NPI:1871819441
Name:MURPHY, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:MURPHY
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 1:7840 E BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-5531
Mailing Address - Country:US
Mailing Address - Phone:928-772-0767
Mailing Address - Fax:928-775-6919
Practice Address - Street 1:7840 E BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-5531
Practice Address - Country:US
Practice Address - Phone:928-772-0767
Practice Address - Fax:928-775-6919
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist