Provider Demographics
NPI:1598750663
Name:MURRAY, JULIANNE RYAN (MSN)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:RYAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:JULIANN
Other - Middle Name:
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:10135 49TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-2527
Mailing Address - Country:US
Mailing Address - Phone:763-559-8771
Mailing Address - Fax:
Practice Address - Street 1:900 NICOLLET MALL
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2530
Practice Address - Country:US
Practice Address - Phone:612-659-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR089687-4363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN368272200Medicaid
MN50000280Medicare PIN
MN368272200Medicaid
500002680Medicare ID - Type Unspecified