Provider Demographics
NPI:1043957483
Name:MURPHY, ERIN GRACE (OD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:GRACE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MURPHY
Other - Last Name:COURNOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:585 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5945
Mailing Address - Country:US
Mailing Address - Phone:207-729-8474
Mailing Address - Fax:
Practice Address - Street 1:585 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5945
Practice Address - Country:US
Practice Address - Phone:207-729-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT1059152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist