Healthcare Provider Details

I. General information

NPI: 1871390492
Provider Name (Legal Business Name): TAYLOR LEIGH MURPHY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N MICHIGAN ST
SOUTH BEND IN
46601-1087
US

IV. Provider business mailing address

1635 COBBLE HILLS DR
OSCEOLA IN
46561-1303
US

V. Phone/Fax

Practice location:
  • Phone: 574-647-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number287274642A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: