Individual provider Active NPI

Lynn Maki Murphy, RN, MSN, CPNP

  • Pediatric Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1689839896
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
341433 Issued in WI
Practice address
622 Bodart St
Green Bay, WI 54301-4923
Phone
(920) 437-9773
NPI assigned
Jul 28, 2008
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 3414-033 WI
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 341433 WI Primary

Addresses

Primary practice location

622 Bodart St
Green Bay, WI 54301-4923

Mailing address

2961 Ancestor Way
Green Bay, WI 54313-8069
Phone (920) 434-4248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250107003985 WI Practitioner - Nurse Practitioner 3274061098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
3414-033WIMDPediatric Registered Nurse
341433WIMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1689839896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 ANCESTOR WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138069",
            "telephone_number": "920-434-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 BODART ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014923",
            "telephone_number": "920-437-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "LYNN",
        "middle_name": "MAKI",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WI",
            "license": "3414-033",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "341433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.