Provider Demographics
NPI:1295499846
Name:MURPHY, ALISA (PMHNP, BSN)
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PMHNP, BSN
Other - Prefix:MS
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:PANGBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:1050 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-2001
Mailing Address - Country:US
Mailing Address - Phone:716-856-2587
Mailing Address - Fax:716-856-2608
Practice Address - Street 1:3117 MILITARY RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4813
Practice Address - Country:US
Practice Address - Phone:716-257-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403776363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health