Provider Demographics
NPI:1780855288
Name:MURPHY, KATHLEEN QUINN (ATC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:QUINN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:LINDA
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:5121 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-1181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 RIVER ST
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1827
Practice Address - Country:US
Practice Address - Phone:978-436-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15342255A2300X
NH03812255A2300X
NJ25MT001170002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer