Provider Demographics
NPI:1699759787
Name:MURPHY, JANET L (APRN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:PEDIATRICS - CLINIC BUILDING
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2470
Mailing Address - Fax:203-688-7274
Practice Address - Street 1:15 YORK ST
Practice Address - Street 2:PEDIATRICS - CLINIC BUILDING
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3221
Practice Address - Country:US
Practice Address - Phone:203-688-2470
Practice Address - Fax:203-688-7274
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001082363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004172558Medicaid
CT500001155Medicare ID - Type Unspecified
CT004172558Medicaid