Provider Demographics
NPI:1275170565
Name:MURRAINE, EBONI CAMIELLE (CRNP)
Entity Type:Individual
Prefix:
First Name:EBONI
Middle Name:CAMIELLE
Last Name:MURRAINE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 ADVENTIST BLVD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35896-0001
Mailing Address - Country:US
Mailing Address - Phone:256-726-7840
Mailing Address - Fax:256-726-7471
Practice Address - Street 1:7000 ADVENTIST BLVD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35896-0001
Practice Address - Country:US
Practice Address - Phone:256-726-7840
Practice Address - Fax:256-726-7471
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2019052147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily