Healthcare Provider Details

I. General information

NPI: 1588283105
Provider Name (Legal Business Name): MADELINE MURPHY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15790 PAUL VEGA MD DR
HAMMOND LA
70403-1436
US

IV. Provider business mailing address

305 E AUGUSTA LN
SLIDELL LA
70458-8830
US

V. Phone/Fax

Practice location:
  • Phone: 985-345-2700
  • Fax: 985-230-2159
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7750
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number131021
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number225794
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: