Provider Demographics
NPI:1447844071
Name:MURPHY, KATHY (LPN)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 COUNTRY WALK
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-7396
Mailing Address - Country:US
Mailing Address - Phone:678-988-1739
Mailing Address - Fax:
Practice Address - Street 1:311 WHITE INGRAM PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-0969
Practice Address - Country:US
Practice Address - Phone:678-363-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN070729164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse