Provider Demographics
NPI:1184666182
Name:MURRAY, FREDA JOYCE (RN, FNP, C)
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:JOYCE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RN, FNP, C
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2044
Practice Address - Country:US
Practice Address - Phone:214-370-1000
Practice Address - Fax:214-370-1850
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228144363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044376404Medicaid
TX044376405Medicaid
TX044376403Medicaid
TX044376403Medicaid
TXP19286Medicare UPIN
TX044376405Medicaid