Provider Demographics
NPI:1912975954
Name:MURPHY, ANN M (PT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9361 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9150
Mailing Address - Country:US
Mailing Address - Phone:763-497-1978
Mailing Address - Fax:
Practice Address - Street 1:21395 JOHN MILLESS DR
Practice Address - Street 2:SUITE 600
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4402
Practice Address - Country:US
Practice Address - Phone:763-428-2589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5638OtherLICENCE NUMBER