Provider Demographics
NPI:1427275783
Name:MURPHY, ANDREA LYNN (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SW FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3011
Mailing Address - Country:US
Mailing Address - Phone:772-873-1975
Mailing Address - Fax:
Practice Address - Street 1:1807 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-7204
Practice Address - Country:US
Practice Address - Phone:772-286-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1377171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist