Provider Demographics
NPI:1700842259
Name:MURPHY, SHIRLEY A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:A
Other - Last Name:KULAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1295 W FAIRFIELD DR
Mailing Address - Street 2:ATTN: SUSIE PITMAN
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1107
Mailing Address - Country:US
Mailing Address - Phone:850-595-6417
Mailing Address - Fax:850-595-6693
Practice Address - Street 1:1295 W FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1107
Practice Address - Country:US
Practice Address - Phone:850-595-6417
Practice Address - Fax:850-595-6693
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1590862363LF0000X, 363LW0102X
FLRN1590862364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033581900Medicaid