Provider Demographics
NPI:1073897773
Name:MURRAY, ANDREA LYNN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMPTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4848
Mailing Address - Country:US
Mailing Address - Phone:603-775-7575
Mailing Address - Fax:603-778-9680
Practice Address - Street 1:1 HAMPTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4848
Practice Address - Country:US
Practice Address - Phone:603-775-7575
Practice Address - Fax:603-778-9680
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4111OtherMEDICARE GP #
NH4111OtherMEDICARE GP #
08Y018780NH05OtherANTHEM / BCBS
08Y018780NH09OtherANTHEM / BCBS
08Y018780NH02OtherANTHEM / BCBS
08Y018780NH06OtherANTHEM / BCBS
NH4111OtherMEDICARE GP #
000000142389OtherWELL SENSE
100833000OtherDEPT OF LABOR
08Y018780NH08OtherANTHEM / BCBS