Provider Demographics
NPI:1689195463
Name:MURRAY, LEANNE (NP-C)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 BENIGNO LN
Mailing Address - Street 2:
Mailing Address - City:BAY SAINT LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-1602
Mailing Address - Country:US
Mailing Address - Phone:228-467-2555
Mailing Address - Fax:228-467-4580
Practice Address - Street 1:1009 BENIGNO LN
Practice Address - Street 2:
Practice Address - City:BAY SAINT LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-1602
Practice Address - Country:US
Practice Address - Phone:228-467-2555
Practice Address - Fax:228-467-4580
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902053363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care