Provider Demographics
NPI:1306358908
Name:MURRAY, GINA LYNNE (CRNP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:LYNNE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4102 CHARDEL RD APT 3F
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5463
Mailing Address - Country:US
Mailing Address - Phone:410-925-3756
Mailing Address - Fax:
Practice Address - Street 1:4102 CHARDEL RD APT 3F
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5463
Practice Address - Country:US
Practice Address - Phone:410-925-3756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-04
Last Update Date:2017-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167237363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner