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NPI Code Detail

MEDICARE: MS. ELIZABETH GULLOTTA MURCHIE MSN

MEDICARE: MS. ELIZABETH GULLOTTA MURCHIE MSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner382314NY
2363L00000XNurse Practitioner5163MN
3363LP0200XPediatric Nurse Practitioner209007674IL
4363LP0808XPsychiatric/Mental Health Nurse Practitioner5163MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699905604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH GULLOTTA MURCHIE MSN
Provider Business Mailing Address
First Line : 819 S SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13202-3527
Country : US
Telephone Number : 315-476-7921
Fax Number : 315-475-1448
Provider Business Practice Location Address
First Line : 8550 HUDSON BLVD N
Second Line :
City : LAKE ELMO
State : MN
Zip : 55042-5500
Country : US
Telephone Number : 651-254-8580
Fax Number : 651-730-1700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2009
Last Update Date : 12/07/2023

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