Healthcare Provider Details

I. General information

NPI: 1447707872
Provider Name (Legal Business Name): JENNIFER MURDOCK APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 MIAMI RD
MONTROSE CO
81401-4108
US

IV. Provider business mailing address

PO BOX 1208
MONTROSE CO
81402-1208
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-9694
  • Fax: 970-249-2955
Mailing address:
  • Phone: 970-252-3200
  • Fax: 970-252-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0992755-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1644088
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number164414-30
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number6965-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: