Provider Demographics
NPI:1245456854
Name:MURPHY, DERAMON ANN
Entity type:Individual
Prefix:
First Name:DERAMON
Middle Name:ANN
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 1:463 PORTOBELLO DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-3264
Mailing Address - Country:US
Mailing Address - Phone:904-683-4780
Mailing Address - Fax:
Practice Address - Street 1:463 PORTOBELLO DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-3264
Practice Address - Country:US
Practice Address - Phone:904-683-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker