Healthcare Provider Details

I. General information

NPI: 1538913546
Provider Name (Legal Business Name): EVELYN NYCOLE MURDOCK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9238 MADISON BLVD STE 114
MADISON AL
35758-9112
US

IV. Provider business mailing address

PO BOX 18428
HUNTSVILLE AL
35804-8428
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-9020
  • Fax: 256-536-4530
Mailing address:
  • Phone: 256-705-4224
  • Fax: 256-705-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-169103
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: