Provider Demographics
NPI:1457532608
Name:MURPHY, BRIAN PATRICK (ARNP)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PATRICK
Last Name:MURPHY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S IOWA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1737
Mailing Address - Country:US
Mailing Address - Phone:319-461-0130
Mailing Address - Fax:319-774-0386
Practice Address - Street 1:315 S IOWA AVE STE A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1737
Practice Address - Country:US
Practice Address - Phone:319-461-0130
Practice Address - Fax:319-774-0386
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2022-08-19
Deactivation Date:2020-08-17
Deactivation Code:
Reactivation Date:2020-09-02
Provider Licenses
StateLicense IDTaxonomies
IAA-104668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1457532608Medicaid
IAP00474251OtherRR MEDICARE
IAP00474251OtherRR MEDICARE