Provider Demographics
NPI:1770544983
Name:ALLEN, MURPHY T (APRN)
Entity type:Individual
Prefix:
First Name:MURPHY
Middle Name:T
Last Name:ALLEN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 WATERVALE DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7657
Mailing Address - Country:US
Mailing Address - Phone:775-626-6042
Mailing Address - Fax:
Practice Address - Street 1:2835 WATERVALE DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7657
Practice Address - Country:US
Practice Address - Phone:775-815-9376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00502363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
11907848OtherCAQH
1770544983OtherNPI
NVCW338XMedicare PIN