Basic Information
Provider Information
NPI: 1487718920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: KATHRINE
MiddleName: ELISA
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4528 RUBY CT NE
Address2:  
City: SALEM
State: OR
PostalCode: 973053100
CountryCode: US
TelephoneNumber: 5038814728
FaxNumber:  
Practice Location
Address1: 3180 CENTER ST NE
Address2:  
City: SALEM
State: OR
PostalCode: 973014532
CountryCode: US
TelephoneNumber: 5035855351
FaxNumber: 5035854908
Other Information
ProviderEnumerationDate: 12/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808X080012266RNORY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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