Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 949 | WY |
NPI | 1508992603 |
---|---|
Provider Name | Kathleen Meehan Murphy |
First Address | Douglas, WY 82633-0688 |
Second Address | Glenrock, WY 82637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |