1376766980 NPI number — CONSTANCE BROWN MURPHY A.R.N.P.

Table of content: CONSTANCE BROWN MURPHY A.R.N.P. (NPI 1376766980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376766980 NPI number — CONSTANCE BROWN MURPHY A.R.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
CONSTANCE
Provider Middle Name:
BROWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
A.R.N.P.
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:
1376766980
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19000 PORTOFINO CIR
Provider Second Line Business Mailing Address:
APT. 122
Provider Business Mailing Address City Name:
PALM BEACH GARDENS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33418-1298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-263-2000
Provider Business Mailing Address Fax Number:
561-575-6095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1025 MILITARY TRL
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-7040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-263-2000
Provider Business Practice Location Address Fax Number:
561-575-6095
Provider Enumeration Date:
04/11/2007

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: 363LW0102X , with the licence number:  ARNP1555612 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000Y6379N . This is a "MEDICARE PROVIDER #000Y6379N" identifier . This identifiers is of the category "OTHER".




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