Provider Demographics
NPI:1992805824
Name:MURPHY, JULIE ANN (CRNA APNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CRNA APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 PINE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-8827
Mailing Address - Country:US
Mailing Address - Phone:920-362-2641
Mailing Address - Fax:
Practice Address - Street 1:1087 W MASON ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-1859
Practice Address - Country:US
Practice Address - Phone:920-499-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131798-030367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44312100Medicaid
0040-21143Medicare ID - Type Unspecified