Provider Demographics
NPI:1366694044
Name:MURRAY, TINA M (NP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1014 FORSYTH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2025
Mailing Address - Country:US
Mailing Address - Phone:478-633-8700
Mailing Address - Fax:478-633-8710
Practice Address - Street 1:1014 FORSYTH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2025
Practice Address - Country:US
Practice Address - Phone:478-633-8700
Practice Address - Fax:478-633-8710
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160381NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily