Healthcare Provider Details

I. General information

NPI: 1033073630
Provider Name (Legal Business Name): CHRISTIAN MURPHY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 GRAY STATION RD APT 56
JOHNSON CITY TN
37615-2492
US

IV. Provider business mailing address

249 GRAY STATION RD APT 56
JOHNSON CITY TN
37615-2492
US

V. Phone/Fax

Practice location:
  • Phone: 865-456-7026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: