Provider Demographics
NPI:1932279742
Name:MURDOCH, PATRICIA WARD (APRN, DNP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:WARD
Last Name:MURDOCH
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 ROUTE 12
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1870
Mailing Address - Country:US
Mailing Address - Phone:860-464-7274
Mailing Address - Fax:860-464-7404
Practice Address - Street 1:1527 ROUTE 12
Practice Address - Street 2:SUITE 101
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1870
Practice Address - Country:US
Practice Address - Phone:860-464-7274
Practice Address - Fax:860-464-7404
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN03018363LF0000X
IL377.00252363L00000X
RI03018363L00000X
IL277.000252363L00000X
IL209003725363LA2100X
CT10342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208905145Medicare PIN
P65129Medicare UPIN
ILK14643Medicare PIN
ILR01082Medicare PIN