Provider Demographics
NPI:1770712499
Name:MURPHY, KIMBERLY (NP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HOLLY HILL LN STE 240
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6074
Mailing Address - Country:US
Mailing Address - Phone:203-785-2815
Mailing Address - Fax:
Practice Address - Street 1:688 WHITE PLAINS RD STE 201
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5015
Practice Address - Country:US
Practice Address - Phone:914-998-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8207363LA2100X
WI4880-33363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1770712499Medicaid