Provider Demographics
NPI:1366822280
Name:MURRAY, KERRY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 GLEN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2716
Mailing Address - Country:US
Mailing Address - Phone:610-717-7570
Mailing Address - Fax:
Practice Address - Street 1:1305 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2929
Practice Address - Country:US
Practice Address - Phone:610-482-4949
Practice Address - Fax:610-237-8701
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057490363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical