Provider Demographics
NPI:1891753430
Name:MURPHY, MAUREEN M (CNMW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CNMW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:24TH FLOOR WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-255-3529
Mailing Address - Fax:215-832-2213
Practice Address - Street 1:1427 VINE ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1031
Practice Address - Country:US
Practice Address - Phone:215-762-7824
Practice Address - Fax:215-246-5257
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008472L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA026784Medicare ID - Type Unspecified
PAS79173Medicare UPIN