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Individual

STEPHANIE M MURPHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4656 40TH AVE S, FARGO, ND 58104-4397
(701) 234-8860
(701) 234-8924
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0779
SD
363AM0700X
Medical Physician Assistant
Primary
PAC0549
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71306
ND
05
71392
ND
Enumeration date
05/11/2011
Last updated
12/26/2014
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