Provider Demographics
NPI:1346539558
Name:MURRAY, MICHELLE MACMAHON (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MACMAHON
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:MACMAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6010 BALCONES DR
Mailing Address - Street 2:STE 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4270
Mailing Address - Country:US
Mailing Address - Phone:512-323-5362
Mailing Address - Fax:
Practice Address - Street 1:6010 BALCONES DR
Practice Address - Street 2:STE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4270
Practice Address - Country:US
Practice Address - Phone:512-323-5362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707991363LG0600X
TXAP120038363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology