MEDICARE: MRS. KRISTIE JEAN MURPHY CNP

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	363LG0600X	Gerontology Nurse Practitioner	CNP181083	ME

General Provider Information

NPI Number	:	1619463072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIE JEAN MURPHY CNP

Provider Business Mailing Address
First Line	:	50 MARQUIS RD
Second Line	:
City	:	FREEPORT
State	:	ME
Zip	:	04032-6477
Country	:	US
Telephone Number	:	207-865-6131
Fax Number	:	207-865-9399

Provider Business Practice Location Address
First Line	:	390 US ROUTE 1
Second Line	:
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074-6713
Country	:	US
Telephone Number	:	207-289-3660
Fax Number	:	207-883-1506

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

Provider Enumeration Date	:	07/09/2018
Last Update Date	:	08/12/2022

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