Provider Demographics
NPI:1578372058
Name:MURPHY, KEISHA NICHOLE (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:KEISHA
Middle Name:NICHOLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7436
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-0436
Mailing Address - Country:US
Mailing Address - Phone:800-414-1202
Mailing Address - Fax:909-435-2522
Practice Address - Street 1:599 N ARROWHEAD AVE UNIT 9
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1201
Practice Address - Country:US
Practice Address - Phone:800-414-1202
Practice Address - Fax:909-435-2522
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health