Provider Demographics
NPI:1326011552
Name:MURRAY, WENDY (NP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 OLD WINTER GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-1348
Mailing Address - Country:US
Mailing Address - Phone:407-751-7288
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:101 ORCHARD PARK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3531
Practice Address - Country:US
Practice Address - Phone:864-729-6609
Practice Address - Fax:855-617-4426
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA2666363LA2200X
SC2666363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0926Medicaid
SCP01478436OtherRAILROAD MEDICARE
SC2666OtherSC MEDICAL BOARD
SCAA1058Medicare UPIN