Provider Demographics
NPI:1629520473
Name:MURRAY, MORGAN (APRN)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:KY
Mailing Address - Zip Code:42220-0487
Mailing Address - Country:US
Mailing Address - Phone:270-886-8840
Mailing Address - Fax:270-886-8869
Practice Address - Street 1:713 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:KY
Practice Address - Zip Code:42220-9229
Practice Address - Country:US
Practice Address - Phone:270-265-5353
Practice Address - Fax:270-265-5350
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010821363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100450420Medicaid