Basic Information
Provider Information
NPI: 1396412532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: LAUREN
MiddleName: NICOLE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 440 JAKE ALEXANDER BLVD W
Address2:  
City: SALISBURY
State: NC
PostalCode: 281471365
CountryCode: US
TelephoneNumber: 7046375767
FaxNumber:  
Practice Location
Address1: 440 JAKE ALEXANDER BLVD W
Address2:  
City: SALISBURY
State: NC
PostalCode: 281471365
CountryCode: US
TelephoneNumber: 7046375767
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/25/2021
LastUpdateDate: 08/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X5014942NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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