Basic Information
| Provider Information | |||||||||
| NPI: | 1245747245 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2944 CASTLEWOOD RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432093015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142166932 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3042 MCKINLEY AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432043653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144877805 | ||||||||
| FaxNumber: | 6144877809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 171M00000X | OH | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.