Provider Demographics
NPI:1043784101
Name:PATRICIA B. MURRAY-DERR
Entity Type:Organization
Organization Name:PATRICIA B. MURRAY-DERR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY-DERR
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:603-883-0016
Mailing Address - Street 1:10 ELIJAH HILL LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3958
Mailing Address - Country:US
Mailing Address - Phone:603-883-0016
Mailing Address - Fax:
Practice Address - Street 1:10 ELIJAH HILL LN
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3958
Practice Address - Country:US
Practice Address - Phone:603-883-0016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty