Provider Demographics
NPI:1518554062
Name:MCMURRAY, KATHRYN NICHOLE
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:NICHOLE
Last Name:MCMURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3745
Mailing Address - Country:US
Mailing Address - Phone:330-717-6572
Mailing Address - Fax:
Practice Address - Street 1:1273 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-3745
Practice Address - Country:US
Practice Address - Phone:330-717-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5005930Medicaid