Basic Information
Provider Information
NPI: 1447694617
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: BRIANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1901 SW H K DODGEN LOOP
Address2:  
City: TEMPLE
State: TX
PostalCode: 765021814
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1600 W 22ND ST
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571051521
CountryCode: US
TelephoneNumber: 6053121000
FaxNumber: 6053121001
Other Information
ProviderEnumerationDate: 04/18/2013
LastUpdateDate: 04/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0207X11756SDY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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