Healthcare Provider Details

I. General information

NPI: 1932062825
Provider Name (Legal Business Name): AMY MARIE MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W BROADWAY AVE
MINNEAPOLIS MN
55411-2533
US

IV. Provider business mailing address

3937 43RD AVE S
MINNEAPOLIS MN
55406-3511
US

V. Phone/Fax

Practice location:
  • Phone: 612-668-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number434896
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: