Provider Demographics
NPI:1255313045
Name:MURPHY, MARY KATHERINE (WHNP/FNP-C)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATHERINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:WHNP/FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MAGNOLIA TER
Mailing Address - Street 2:
Mailing Address - City:FLAGLER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32136-3473
Mailing Address - Country:US
Mailing Address - Phone:386-503-3908
Mailing Address - Fax:
Practice Address - Street 1:306 UNION AVE
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:FL
Practice Address - Zip Code:32112-4432
Practice Address - Country:US
Practice Address - Phone:386-698-1232
Practice Address - Fax:386-325-1086
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2120582363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health