Provider Demographics
NPI:1124455233
Name:MURPHY, MICHELLE LYNN (BS, CAC II)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:BS, CAC II
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12225 NEWPORT DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-9619
Mailing Address - Country:US
Mailing Address - Phone:720-224-5302
Mailing Address - Fax:
Practice Address - Street 1:1450 S ASH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3629
Practice Address - Country:US
Practice Address - Phone:303-725-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB0007675171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator