Provider Demographics
NPI:1730770116
Name:MURPHY, MYKIA SEQUETTE
Entity type:Individual
Prefix:MS
First Name:MYKIA
Middle Name:SEQUETTE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 LISBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3400
Mailing Address - Country:US
Mailing Address - Phone:240-432-5432
Mailing Address - Fax:
Practice Address - Street 1:2006 SAVANNAH PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2108
Practice Address - Country:US
Practice Address - Phone:202-678-7049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant