Individual
STACI C MURPHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PNP
Contact information
Practice address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
(812) 339-6434
(812) 331-0196
Mailing address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
(812) 339-6434
(812) 331-0196
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
71002004A
IN
363L00000X
Nurse Practitioner
Primary
71002004A
IN
363LF0000X
Family Nurse Practitioner
71002004A
IN
363LP0200X
Pediatric Nurse Practitioner
71002004A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200531520
—
IN
Enumeration date
07/15/2006
Last updated
06/11/2020
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