Provider Demographics
NPI:1346482049
Name:MURREY, NICOLE A (MS)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:A
Last Name:MURREY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 ATLANTIC BLVD UNIT 17
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-2258
Mailing Address - Country:US
Mailing Address - Phone:904-304-9465
Mailing Address - Fax:904-304-9465
Practice Address - Street 1:5811 ATLANTIC BLVD
Practice Address - Street 2:#17
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2214
Practice Address - Country:US
Practice Address - Phone:904-304-9465
Practice Address - Fax:904-304-9465
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-07-3623103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst