Healthcare Provider Details

I. General information

NPI: 1124734819
Provider Name (Legal Business Name): HALEY ELIZABETH MURPHY APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. HALEY ELIZABETH FUSTING

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4003 KRESGE WAY STE 410
LOUISVILLE KY
40207-4652
US

IV. Provider business mailing address

413 KEENELAND DR
MOUNT WASHINGTON KY
40047-7534
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-7462
  • Fax:
Mailing address:
  • Phone: 502-526-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018826
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3018826
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: