Provider Demographics
NPI:1881454353
Name:MURPHY, WALIDA MUTIYA (RN)
Entity type:Individual
Prefix:
First Name:WALIDA
Middle Name:MUTIYA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 MIX AVE APT L12
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2146
Mailing Address - Country:US
Mailing Address - Phone:203-980-6697
Mailing Address - Fax:
Practice Address - Street 1:835 MIX AVE APT L12
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2146
Practice Address - Country:US
Practice Address - Phone:203-980-6697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10.106670163WM0705X, 163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical