Provider Demographics
NPI:1780121558
Name:MURPHY, JUDY GURGANUS
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:GURGANUS
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JUDY
Other - Middle Name:GURGANUS
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:908 NC HIGHWAY 53 E
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-4585
Mailing Address - Country:US
Mailing Address - Phone:910-789-6006
Mailing Address - Fax:910-789-6007
Practice Address - Street 1:908 NC HIGHWAY 53 E
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-4585
Practice Address - Country:US
Practice Address - Phone:910-789-6006
Practice Address - Fax:910-789-6007
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70281835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC388614OtherNABP