1124394408 NPI number — MRS. JILL NOREEN MURPHY REGISTERED NURSE

Table of content: MRS. JILL NOREEN MURPHY REGISTERED NURSE (NPI 1124394408)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124394408 NPI number — MRS. JILL NOREEN MURPHY REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
JILL
Provider Middle Name:
NOREEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124394408
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 SCHOOL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTRAL SQUARE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13036-3501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-676-4731
Provider Business Mailing Address Fax Number:
315-676-2768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 SCHOOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRAL SQUARE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13036-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-676-4731
Provider Business Practice Location Address Fax Number:
315-676-2768
Provider Enumeration Date:
03/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  446384 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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