Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 21160071638 | MI |
NPI | 1003488537 |
---|---|
Provider Name | Morgan Murdock |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-1051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2021 |
Last Update Date | 14/07/2021 |