Provider Demographics
NPI: | 1265516298 |
---|---|
Name: | SANTOM MURPHY, CATHERINE (RNP) |
Entity type: | Individual |
Prefix: | |
First Name: | CATHERINE |
Middle Name: | |
Last Name: | SANTOM MURPHY |
Suffix: | |
Gender: | F |
Credentials: | RNP |
Other - Prefix: | |
Other - First Name: | CATHERINE |
Other - Middle Name: | ANN |
Other - Last Name: | SANTOM |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | RNP |
Mailing Address - Street 1: | 96 AMESBURY ST |
Mailing Address - Street 2: | |
Mailing Address - City: | DRACUT |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01826-5606 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 978-852-6013 |
Mailing Address - Fax: | 781-246-1446 |
Practice Address - Street 1: | 30 NEWCROSSING RD |
Practice Address - Street 2: | SUITE # 310 |
Practice Address - City: | READING |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01867-3254 |
Practice Address - Country: | US |
Practice Address - Phone: | 781-944-1166 |
Practice Address - Fax: | 781-944-1168 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-25 |
Last Update Date: | 2007-07-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | 145682 | 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | 0382141 | Medicaid | |
MA | NP0921 | Other | BC/BS MA |
MA | NP0921 | Other | BC/BS MA |
MA | NP0921 | Medicare ID - Type Unspecified |