Provider Demographics
NPI:1487645735
Name:MURRAY, LINDA M (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:CRUIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6325 BLUE RIDGE BLVD
Mailing Address - Street 2:#C
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4886
Mailing Address - Country:US
Mailing Address - Phone:816-353-3050
Mailing Address - Fax:816-358-4210
Practice Address - Street 1:6325 BLUE RIDGE BLVD
Practice Address - Street 2:#C
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4886
Practice Address - Country:US
Practice Address - Phone:816-353-3050
Practice Address - Fax:816-358-4210
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO082450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOQ47435Medicare UPIN
MOI30D944AMedicare ID - Type Unspecified