Provider Demographics
NPI:1326116690
Name:MURRAY-DERR, PATRICIA BRADLEY (RD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:BRADLEY
Last Name:MURRAY-DERR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ELIJAH HILL LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3958
Mailing Address - Country:US
Mailing Address - Phone:603-883-0016
Mailing Address - Fax:603-883-0016
Practice Address - Street 1:10 ELIJAH HILL LN
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3958
Practice Address - Country:US
Practice Address - Phone:603-883-0016
Practice Address - Fax:603-883-0016
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH72133V00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered