Basic Information
| Provider Information | |||||||||
| NPI: | 1699241323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | RANDI | ||||||||
| MiddleName: | MARAE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28 RACETRACK RD SPC 21 | ||||||||
| Address2: | |||||||||
| City: | ARENAS VALLEY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880229763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753130979 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 114 W 11TH ST | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880615136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753881511 | ||||||||
| FaxNumber: | 5753138234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2018 | ||||||||
| LastUpdateDate: | 04/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 54355 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.