Provider Demographics
NPI:1104273903
Name:MURPHY, MAUREEN P (RN)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:P
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:ONETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95696-0905
Mailing Address - Country:US
Mailing Address - Phone:707-880-9425
Mailing Address - Fax:
Practice Address - Street 1:200 DEMAREST DR
Practice Address - Street 2:#812
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6465
Practice Address - Country:US
Practice Address - Phone:707-880-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-21
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse