Provider Demographics
NPI:1275086019
Name:MURRY, BRITTANY SHANTEL (CRNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SHANTEL
Last Name:MURRY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:SHANTEL
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:103 BROOKWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-8143
Mailing Address - Country:US
Mailing Address - Phone:251-375-0145
Mailing Address - Fax:
Practice Address - Street 1:9677 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-4271
Practice Address - Country:US
Practice Address - Phone:251-368-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136623363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology