Provider Demographics
NPI:1497897557
Name:MURISON, LYNNE G (RN, CFNP)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:G
Last Name:MURISON
Suffix:
Gender:F
Credentials:RN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29024 HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-7951
Mailing Address - Country:US
Mailing Address - Phone:970-385-5524
Mailing Address - Fax:
Practice Address - Street 1:744 W ANIMAS ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5617
Practice Address - Country:US
Practice Address - Phone:505-327-4461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR34526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily