Healthcare Provider Details

I. General information

NPI: 1891632527
Provider Name (Legal Business Name): KELLY MAUREEN MURPHY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6186 HORSEVIEW DR
SPRINGFIELD IL
62712-8666
US

IV. Provider business mailing address

6186 HORSEVIEW DR
SPRINGFIELD IL
62712-8666
US

V. Phone/Fax

Practice location:
  • Phone: 217-825-8805
  • Fax: 217-825-8805
Mailing address:
  • Phone: 217-825-8805
  • Fax: 217-825-8805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041384857
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: