MEDICARE: TABITHA LYNN MURPHY FNP

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	363LF0000X	Family Nurse Practitioner	71012099A	IN

General Provider Information

NPI Number	:	1700537982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABITHA LYNN MURPHY FNP

Provider Business Mailing Address
First Line	:	1205 AMERICAN AVE
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-3268
Country	:	US
Telephone Number	:	317-794-9786
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 MONUMENT CIR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-2921
Country	:	US
Telephone Number	:	317-761-7524
Fax Number	:

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

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	10/31/2024

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