Provider Demographics
NPI:1013418805
Name:MURRAY, JAIME LEE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:LEE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:MURRAY
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-3564
Practice Address - Fax:703-776-2338
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010500207Q00000X
TXAP136759207Q00000X
VA0024182578363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty