Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1144679440 |
---|---|
Provider Name | Ashley Murphy |
First Address | Fort Hood, TX 76544 |
Second Address | Fort Hood, TX 76544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2016 |
Last Update Date | 07/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1365679696 | DOD ID (01) |