Provider Demographics
NPI:1164288445
Name:FIELDS-MURRAY, JONATA LENAY (FNP)
Entity Type:Individual
Prefix:
First Name:JONATA
Middle Name:LENAY
Last Name:FIELDS-MURRAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:CHUNCHULA
Mailing Address - State:AL
Mailing Address - Zip Code:36521-0038
Mailing Address - Country:US
Mailing Address - Phone:678-304-0461
Mailing Address - Fax:
Practice Address - Street 1:1300 MCWILLIAMS RD SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5736
Practice Address - Country:US
Practice Address - Phone:678-304-0461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN292904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily