Provider Demographics
NPI:1215331699
Name:MURPHY, STEPHANIE ADRIENNE (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ADRIENNE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:ADRIENNE
Other - Last Name:HALDEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:15601 N 28TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4061
Mailing Address - Country:US
Mailing Address - Phone:602-938-5800
Mailing Address - Fax:
Practice Address - Street 1:15601 N 28TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-4061
Practice Address - Country:US
Practice Address - Phone:602-938-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5817363AS0400X
TXPA10754363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ038266OtherAHCCCS