Provider Demographics
NPI:1649445578
Name:MURPHY, KRISTEN S (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:S
Last Name:MURPHY
Suffix:
Gender:F
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:PO BOX 540547
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32954-0547
Mailing Address - Country:US
Mailing Address - Phone:321-221-7447
Mailing Address - Fax:321-221-7448
Practice Address - Street 1:1790 HIGHWAY A1A STE 205
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-5440
Practice Address - Country:US
Practice Address - Phone:321-221-7447
Practice Address - Fax:321-221-7448
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9218483363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000050200Medicaid
FLP00631819OtherRR MEDICARE