Provider Demographics
NPI:1083472781
Name:MURRAY, NICOLE MARIE (MED)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2261
Mailing Address - Country:US
Mailing Address - Phone:603-548-3806
Mailing Address - Fax:
Practice Address - Street 1:207 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-8111
Practice Address - Country:US
Practice Address - Phone:603-966-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH91683103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist