Provider Demographics
NPI:1356518740
Name:MURPHY, KRYSTAL LYN (LPN)
Entity type:Individual
Prefix:MS
First Name:KRYSTAL
Middle Name:LYN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-4348
Mailing Address - Country:US
Mailing Address - Phone:612-788-8912
Mailing Address - Fax:
Practice Address - Street 1:433 S 7TH ST
Practice Address - Street 2:APT. 1923
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1626
Practice Address - Country:US
Practice Address - Phone:612-305-0972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL-055162-7164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse