Provider Demographics
NPI:1508029687
Name:MCMURRY, MARY K (CNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:MCMURRY
Suffix:
Gender:F
Credentials:CNP
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Mailing Address - Street 1:4600 MONTGOMERY RD
Mailing Address - Street 2:STE 105
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2697
Mailing Address - Country:US
Mailing Address - Phone:513-487-5305
Mailing Address - Fax:513-487-5317
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:STE 325
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-861-0800
Practice Address - Fax:513-861-5111
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2014-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH03611-NP363LA2200X
KY3001842363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2195539Medicaid
KY78007333Medicaid