Provider Demographics
NPI:1629867080
Name:MURPHY, KARISA LEANN (LAT, ATC)
Entity type:Individual
Prefix:
First Name:KARISA
Middle Name:LEANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:KARISA
Other - Middle Name:LEANN
Other - Last Name:WALNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 CYRUS THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7708
Mailing Address - Country:US
Mailing Address - Phone:253-229-3349
Mailing Address - Fax:
Practice Address - Street 1:HP135B C STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546
Practice Address - Country:US
Practice Address - Phone:910-451-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC44232255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer