Provider Demographics
NPI:1447067863
Name:MURPHY, KENDAL MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KENDAL
Middle Name:MARIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 WORTHINGTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2821
Mailing Address - Country:US
Mailing Address - Phone:302-562-9575
Mailing Address - Fax:
Practice Address - Street 1:644 S QUEEN ST STE 106
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3543
Practice Address - Country:US
Practice Address - Phone:302-678-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0012190363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant