Provider Demographics
NPI:1265693436
Name:MURCH, EULA J
Entity type:Individual
Prefix:
First Name:EULA
Middle Name:J
Last Name:MURCH
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 1:20551 BOWEN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917-4963
Mailing Address - Country:US
Mailing Address - Phone:239-543-1534
Mailing Address - Fax:239-997-2069
Practice Address - Street 1:20551 BOWEN RD
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33917-4963
Practice Address - Country:US
Practice Address - Phone:239-543-1534
Practice Address - Fax:239-997-2069
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL089050-A373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL682828196Medicaid