Provider Demographics
NPI:1538991294
Name:MURDOCK, ANDRENE OLIVIA (PMHNP)
Entity type:Individual
Prefix:
First Name:ANDRENE
Middle Name:OLIVIA
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 ALHAMBRA CREST DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-7914
Mailing Address - Country:US
Mailing Address - Phone:267-261-0970
Mailing Address - Fax:
Practice Address - Street 1:1510 ALHAMBRA CREST DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-7914
Practice Address - Country:US
Practice Address - Phone:267-261-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9534404163WP0808X
FLAPRN11032897363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health