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NPI Code Detail

MEDICARE: JORDAN R MURPHY PHD, RN, CPNP-PC

MEDICARE: JORDAN R MURPHY PHD, RN, CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered NurseRN252467GA
2163WP0807XChild & Adolescent Psychiatric/Mental Health Registered NurseRN252467GA
3163WP0809XAdult Psychiatric/Mental Health Registered NurseRN252467GA
4363LP0200XPediatric Nurse PractitionerRN252467GA

General Provider Information

NPI Number : 1174125637
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN R MURPHY PHD, RN, CPNP-PC
Provider Business Mailing Address
First Line : 173 BOULEVARD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1468
Country : US
Telephone Number : 404-658-1500
Fax Number :
Provider Business Practice Location Address
First Line : 173 BOULEVARD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1468
Country : US
Telephone Number : 404-658-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2020
Last Update Date : 01/18/2022

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