Provider Demographics
NPI:1649455270
Name:MURPHY, BETTY J (LPN)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:J
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 1:6413 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2228
Mailing Address - Country:US
Mailing Address - Phone:440-205-1076
Mailing Address - Fax:440-428-8272
Practice Address - Street 1:6413 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2228
Practice Address - Country:US
Practice Address - Phone:440-205-1076
Practice Address - Fax:440-428-8272
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-090261164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2325380Medicaid