Provider Demographics
NPI:1164103487
Name:MURRAY, GRACE E (MS, RDN, LDN)
Entity Type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:E
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 RILEY HOSPITAL DR # XE070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5272
Mailing Address - Country:US
Mailing Address - Phone:131-794-4369
Mailing Address - Fax:317-948-7095
Practice Address - Street 1:575 RILEY HOSPITAL DR # XE070
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5272
Practice Address - Country:US
Practice Address - Phone:131-794-4369
Practice Address - Fax:317-948-7095
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37003672A133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric