Provider Demographics
NPI:1093155749
Name:MURRAY, CORRINE ANNE
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:ANNE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 SPRINGVALE CT
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3149
Mailing Address - Country:US
Mailing Address - Phone:218-348-6888
Mailing Address - Fax:
Practice Address - Street 1:2308 SPRINGVALE CT
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3149
Practice Address - Country:US
Practice Address - Phone:218-348-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant