Provider Demographics
NPI:1659567618
Name:MURRAY, KIRSTY KRISTEN
Entity Type:Individual
Prefix:
First Name:KIRSTY
Middle Name:KRISTEN
Last Name:MURRAY
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 1:477 LOMBARD ST # A
Mailing Address - Street 2:APT 1A
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-7502
Mailing Address - Country:US
Mailing Address - Phone:904-303-3219
Mailing Address - Fax:
Practice Address - Street 1:477 LOMBARD ST # A
Practice Address - Street 2:APT 1A
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-7502
Practice Address - Country:US
Practice Address - Phone:904-303-3219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program