Healthcare Provider Details

I. General information

NPI: 1235389016
Provider Name (Legal Business Name): MEGAN DIANE MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 SAWYER DR SUITE 100
DURANGO CO
81303-3409
US

IV. Provider business mailing address

185 SUTTLE ST. ATTN: AXIS HEALTH CENTER-CREDENTIALING
DURANGO CO
81303-8276
US

V. Phone/Fax

Practice location:
  • Phone: 970-385-3491
  • Fax:
Mailing address:
  • Phone: 970-335-2232
  • Fax: 970-565-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09923178
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: