Provider Demographics
NPI:1134809577
Name:MURPHY, KAITLYN JOHNSON (ACNPC-AG)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:JOHNSON
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 BEECH SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:LA
Mailing Address - Zip Code:71268-1098
Mailing Address - Country:US
Mailing Address - Phone:318-669-1225
Mailing Address - Fax:
Practice Address - Street 1:503 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5327
Practice Address - Country:US
Practice Address - Phone:318-329-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA231768363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care