Provider Demographics
NPI:1649345828
Name:MURPHY, MARY ELIZABETH (RN,CNS,AOCN,CHPN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN,CNS,AOCN,CHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1890
Mailing Address - Country:US
Mailing Address - Phone:937-256-4490
Mailing Address - Fax:937-258-5516
Practice Address - Street 1:324 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1890
Practice Address - Country:US
Practice Address - Phone:937-256-4490
Practice Address - Fax:937-258-5516
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH165124364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist