Provider Demographics
NPI:1528680493
Name:MURPHY, LAUREN KENDRA
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KENDRA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37530 JEFFERSON AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2687
Mailing Address - Country:US
Mailing Address - Phone:517-490-3892
Mailing Address - Fax:
Practice Address - Street 1:37530 JEFFERSON AVE APT 104
Practice Address - Street 2:
Practice Address - City:HARRISON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48045-2687
Practice Address - Country:US
Practice Address - Phone:517-490-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703123339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse