Provider Demographics
NPI:1306166913
Name:MURPHY, REBECCA LYNN (KCSA)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:MURPHY
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Gender:F
Credentials:KCSA
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Mailing Address - Street 1:3240 MOUNT MORIAH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7805
Mailing Address - Country:US
Mailing Address - Phone:270-686-6168
Mailing Address - Fax:270-686-6140
Practice Address - Street 1:3240 MOUNT MORIAH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7805
Practice Address - Country:US
Practice Address - Phone:270-686-6168
Practice Address - Fax:270-686-6140
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64294226Medicaid
KY1560101Medicare UPIN