Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F308481-1 | NY |
NPI | 1023520038 |
---|---|
Provider Name | Miss Michaela Marie Murphy |
First Address | Syracuse, NY 13203-1845 |
Second Address | Syracuse, NY 13203-1845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2017 |
Last Update Date | 31/10/2017 |