Provider Demographics
NPI:1811727027
Name:MURPHY, MARY ELAINE (CERTIFIED NUTRITION)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELAINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CERTIFIED NUTRITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BRENNAN ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4303
Mailing Address - Country:US
Mailing Address - Phone:831-768-0220
Mailing Address - Fax:831-768-8469
Practice Address - Street 1:30 BRENNAN ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4303
Practice Address - Country:US
Practice Address - Phone:831-768-0220
Practice Address - Fax:831-768-8469
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist