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General NPI Number Information
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NPI Number | 1962295048
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Entity Type | Organization
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Legal Business Name | ON THE GO NEUROLOGY
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 2220 S VALLE VERDE
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City | MESA
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State | AZ
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Zip | 85209-1529
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Country | US
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Telephone | 480-544-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 S VALLE VERDE
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City | MESA
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State | AZ
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Zip | 85209-1529
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Country | US
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Telephone | 480-544-3417
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JACQUELINE LORRIENE MURPHY
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Credential | DNP, APRN, FNP-BC
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Telephone | 480-544-3417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WN0800X
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Taxonomy Name | Neuroscience Registered Nurse
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License Number |
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License Number State | NULL
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