Provider Demographics
NPI:1972912897
Name:MURPHY, CHANEL O (NP)
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:O
Last Name:MURPHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PARK RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8593
Mailing Address - Country:US
Mailing Address - Phone:877-693-5700
Mailing Address - Fax:954-367-8523
Practice Address - Street 1:300 S PARK RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8593
Practice Address - Country:US
Practice Address - Phone:877-693-5700
Practice Address - Fax:954-367-8523
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR864333363L00000X
FLARNP9291294363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner