Provider Demographics
NPI:1689123184
Name:MURRAY, STEPHANIE M
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:VILLARREAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:341 NANCY ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49548-5945
Mailing Address - Country:US
Mailing Address - Phone:616-890-9333
Mailing Address - Fax:
Practice Address - Street 1:341 NANCY ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49548-5945
Practice Address - Country:US
Practice Address - Phone:616-890-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other