Provider Demographics
NPI:1437142247
Name:MURRAY, MARSHA LOUISE (CFNP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:LOUISE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 FAIRFIELD AVE
Mailing Address - Street 2:STE 411
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4443
Mailing Address - Country:US
Mailing Address - Phone:318-424-4224
Mailing Address - Fax:318-424-4044
Practice Address - Street 1:1801 FAIRFIELD AVE
Practice Address - Street 2:STE 411
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4443
Practice Address - Country:US
Practice Address - Phone:318-424-4224
Practice Address - Fax:318-424-4044
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN035010363L00000X
LAAP03913363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P49917Medicare UPIN
4C103Medicare ID - Type Unspecified
5CC56Medicare ID - Type Unspecified