Basic Information
Provider Information
NPI: 1780240994
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: MICHAEL
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2011 LANCASTER PL
Address2:  
City: PIERRE
State: SD
PostalCode: 575014901
CountryCode: US
TelephoneNumber: 6053703533
FaxNumber:  
Practice Location
Address1: 801 E SIOUX AVE
Address2:  
City: PIERRE
State: SD
PostalCode: 575013323
CountryCode: US
TelephoneNumber: 6052243100
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/13/2019
LastUpdateDate: 05/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XCR001013SDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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