Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704125452 | MI |
NPI | 1013080118 |
---|---|
Provider Name | Ms. Anne Marie Murphy |
First Address | Monroe, MI 48162-7919 |
Second Address | Monroe, MI 48162-7919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5008702920 | BCBS (01) | MI |