1669436853 NPI number — MELODY H MURPHY FNP-BC

Table of content: MELODY H MURPHY FNP-BC (NPI 1669436853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669436853 NPI number — MELODY H MURPHY FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
MELODY
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUSKIN
Provider Other First Name:
MELODY
Provider Other Middle Name:
H.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669436853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
176 MEDICAL CENTER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAINELLE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25962-1064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-438-6188
Provider Business Mailing Address Fax Number:
304-438-6819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26737 MIDLAND TRAIL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICO
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-969-8080
Provider Business Practice Location Address Fax Number:
304-658-3999
Provider Enumeration Date:
04/14/2006

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: 363L00000X , with the licence number:  57241 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3810005940 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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