Provider Demographics
NPI:1801477179
Name:MURPHY, EBONI JENA'
Entity type:Individual
Prefix:
First Name:EBONI
Middle Name:JENA'
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 LOCHIEL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-1801
Mailing Address - Country:US
Mailing Address - Phone:314-885-5994
Mailing Address - Fax:
Practice Address - Street 1:9990 LOCHIEL LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-1801
Practice Address - Country:US
Practice Address - Phone:314-885-5994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health