Provider Demographics
NPI:1407239783
Name:MURRY, CARLETTE (MA)
Entity Type:Individual
Prefix:MS
First Name:CARLETTE
Middle Name:
Last Name:MURRY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 34TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-3570
Mailing Address - Country:US
Mailing Address - Phone:616-325-4594
Mailing Address - Fax:
Practice Address - Street 1:1145 34TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-3570
Practice Address - Country:US
Practice Address - Phone:616-325-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other