Provider Demographics
NPI:1407557432
Name:MURRAY, AUDREY (CBE)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CBE
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:GENTRY-BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBE
Mailing Address - Street 1:22549 LOST CREEK TER APT 204
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6270
Mailing Address - Country:US
Mailing Address - Phone:718-674-4255
Mailing Address - Fax:
Practice Address - Street 1:22549 LOST CREEK TER
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-6269
Practice Address - Country:US
Practice Address - Phone:718-674-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN