1245205426 NPI number — MRS. MARY K MURPHY MSN APRN BC-FNP

Table of content: MRS. MARY K MURPHY MSN APRN BC-FNP (NPI 1245205426)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245205426 NPI number — MRS. MARY K MURPHY MSN APRN BC-FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
MARY
Provider Middle Name:
K
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN APRN BC-FNP
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:
1245205426
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKINS
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26241-0390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-636-9242
Provider Business Mailing Address Fax Number:
304-636-8152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 GORMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKINS
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26241-4109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-636-9242
Provider Business Practice Location Address Fax Number:
304-636-8152
Provider Enumeration Date:
02/21/2006

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:  35192 , 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: 02639382 . This is a "ANCC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001710221 . This is a "MTN STATE BC/BS PAY TO 1" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 35192 . This is a "WV APRN, BC LICENSE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: RXA1276 . This is a "WV PRESCRIPTIVE PRIVILEGE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001768018 . This is a "MTN STATE BC/BS SERVICE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 00349930 . This is a "ANA WV NURSES ASSOC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 734583 . This is a "NCPPO" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 500014647 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: FQ35192 . This is a "HEALTH PLAN PROVIDER" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001967354 . This is a "MTN STATE BC/BS PAY TO 2" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 3810005339 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1047478 . This is a "BRICKSTREET WORKERS COMP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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