Provider Demographics
NPI:1689839896
Name:MURPHY, LYNN MAKI (RN, MSN, CPNP)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MAKI
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 ANCESTOR WAY
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-8069
Mailing Address - Country:US
Mailing Address - Phone:920-434-4248
Mailing Address - Fax:
Practice Address - Street 1:622 BODART ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4923
Practice Address - Country:US
Practice Address - Phone:920-437-9773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3414-033163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics