Healthcare Provider Details

I. General information

NPI: 1558809046
Provider Name (Legal Business Name): JOHANNA RACHEL MURPHY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 BELMONT AVE
BRATTLEBORO VT
05301-6614
US

IV. Provider business mailing address

939 MEADOWBROOK ROAD
BRATTLEBORO VT
05301
US

V. Phone/Fax

Practice location:
  • Phone: 802-257-0341
  • Fax:
Mailing address:
  • Phone: 617-365-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101.0132310
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2268640
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: