Provider Demographics
NPI:1740729961
Name:MURPHY, ALICIA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ANN
Other - Last Name:GASPAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52930 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52930 MOUND RD
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-3265
Practice Address - Country:US
Practice Address - Phone:586-992-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704275569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily