Provider Demographics
NPI:1144084484
Name:WISDOM MURPHY, CHERYL (MS RN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WISDOM MURPHY
Suffix:
Gender:F
Credentials:MS RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9529
Mailing Address - Country:US
Mailing Address - Phone:616-868-7551
Mailing Address - Fax:
Practice Address - Street 1:10015 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-9529
Practice Address - Country:US
Practice Address - Phone:616-868-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704150073163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory