Provider Demographics
NPI:1770266686
Name:MURILLO, STEPHANIE (CPM, LM)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MURILLO
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 HUECO AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3012
Mailing Address - Country:US
Mailing Address - Phone:915-562-2222
Mailing Address - Fax:844-890-2713
Practice Address - Street 1:4130 HUECO AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3012
Practice Address - Country:US
Practice Address - Phone:915-562-2222
Practice Address - Fax:844-890-2713
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99519176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife