Provider Demographics
NPI:1871997262
Name:MURPHY, KAITLYN
Entity type:Individual
Prefix:MISS
First Name:KAITLYN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 SW OLYMPIC CLUB TER
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-6044
Mailing Address - Country:US
Mailing Address - Phone:772-215-5560
Mailing Address - Fax:
Practice Address - Street 1:2265 SW OLYMPIC CLUB TER
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-6044
Practice Address - Country:US
Practice Address - Phone:772-215-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist