Provider Demographics
NPI:1437745106
Name:MCMURPHY, SHANE TIMOTHY (APRN, FNP-BC, RNFA)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:TIMOTHY
Last Name:MCMURPHY
Suffix:
Gender:M
Credentials:APRN, FNP-BC, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 E CERRADA LOS PALITOS
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4219
Mailing Address - Country:US
Mailing Address - Phone:928-310-4614
Mailing Address - Fax:
Practice Address - Street 1:2815 E CERRADA LOS PALITOS
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4219
Practice Address - Country:US
Practice Address - Phone:928-310-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ316858363LF0000X
AZRN205967163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant