MEDICARE: MS. MARY K MURPHY APNP

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
1	363L00000X	Nurse Practitioner	305-033	WI
2	363L00000X	Nurse Practitioner	84816-030	WI

General Provider Information

NPI Number	:	1346357761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY K MURPHY APNP

Provider Business Mailing Address
First Line	:	3301 W FOREST HOME AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-2843
Country	:	US
Telephone Number	:	414-647-6326
Fax Number	:	414-671-8860

Provider Business Practice Location Address
First Line	:	8675 N PORT WASHINGTON RD
Second Line	:
City	:	FOX POINT
State	:	WI
Zip	:	53217-2209
Country	:	US
Telephone Number	:	414-352-2011
Fax Number	:	414-351-7324

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/24/2021

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