Provider Demographics
NPI:1396775227
Name:MURPHY, STEPHEN BAKER (CRNA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BAKER
Last Name:MURPHY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:BAKER
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1647 W BRILES RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-1801
Mailing Address - Country:US
Mailing Address - Phone:219-308-8516
Mailing Address - Fax:
Practice Address - Street 1:1850 N CENTRAL AVE STE 1600
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4633
Practice Address - Country:US
Practice Address - Phone:602-262-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28159102A367500000X
NMCRNA-55596367500000X
AZCRNA1402367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200808160Medicaid
IN229180SMedicare PIN