Provider Demographics
NPI:1295346807
Name:MURPH, KAYLEE MCCUTCHEON
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MCCUTCHEON
Last Name:MURPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:ELIZABETH
Other - Last Name:MCCUTCHEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:133 EAST DR APT 104
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 EAST DR APT 104
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3437
Practice Address - Country:US
Practice Address - Phone:941-525-6452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13350187-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant