Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95013571 | CA |
NPI | 1013547090 |
---|---|
Provider Name | Erin Elizabeth Murdock |
First Address | Fairfield, CA 94534-6694 |
Second Address | Fairfield, CA 94534-6694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2020 |
Last Update Date | 18/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP95013571 | CERIFICATION NUMBER (01) | CA |