Healthcare Provider Details

I. General information

NPI: 1740990563
Provider Name (Legal Business Name): AMBER LEIGH MURPHY AGAC-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/02/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 STATE STREET KAGAN BUILDING #2
BANGOR ME
04401-6616
US

IV. Provider business mailing address

72 NICKERSON HILL RD
CLIFTON ME
04428-6106
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7000
  • Fax:
Mailing address:
  • Phone: 207-299-8572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP221628
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP221628
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: