MEDICARE: MS. LYNN MAKI MURPHY RN, MSN, CPNP

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	163WP0200X	Pediatric Registered Nurse	3414-033	WI
2	363LP0200X	Pediatric Nurse Practitioner	341433	WI

General Provider Information

NPI Number	:	1689839896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNN MAKI MURPHY RN, MSN, CPNP

Provider Business Mailing Address
First Line	:	2961 ANCESTOR WAY
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54313-8069
Country	:	US
Telephone Number	:	920-434-4248
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 BODART ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-4923
Country	:	US
Telephone Number	:	920-437-9773
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	04/21/2025

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