Provider Demographics
NPI:1831524040
Name:MURDEN, STEPHANIE MARIE
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:MURDEN
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 1:5031 WAGENSCHUTZ RD.
Mailing Address - Street 2:
Mailing Address - City:KALKASKA
Mailing Address - State:MI
Mailing Address - Zip Code:49646
Mailing Address - Country:US
Mailing Address - Phone:231-384-0554
Mailing Address - Fax:
Practice Address - Street 1:5031 WAGENSCHUTZ RD.
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646
Practice Address - Country:US
Practice Address - Phone:231-384-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker