Provider Demographics
NPI:1437973591
Name:MURPHY, BRANNAN (RDN)
Entity type:Individual
Prefix:
First Name:BRANNAN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HOWARD ST APT 1014
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-4052
Mailing Address - Country:US
Mailing Address - Phone:563-554-9113
Mailing Address - Fax:
Practice Address - Street 1:415 HOWARD ST APT 1014
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-4052
Practice Address - Country:US
Practice Address - Phone:563-554-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered