Provider Demographics
NPI:1922496017
Name:NORTHERN VALLEY PRIMARY CARE
Entity Type:Organization
Organization Name:NORTHERN VALLEY PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED REGISTERED NURSE PRACTITI
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHLEEM
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP, FNP-C
Authorized Official - Phone:610-360-8751
Mailing Address - Street 1:44 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-1221
Mailing Address - Country:US
Mailing Address - Phone:610-261-0999
Mailing Address - Fax:
Practice Address - Street 1:44 W 21ST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1221
Practice Address - Country:US
Practice Address - Phone:610-261-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty