Provider Demographics
NPI:1720401805
Name:MURRAY, NANCY PATRICIA (RN)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:PATRICIA
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MINEOLA AVE
Mailing Address - Street 2:PO BOX 498
Mailing Address - City:POINT LOOKOUT
Mailing Address - State:NY
Mailing Address - Zip Code:11569-3023
Mailing Address - Country:US
Mailing Address - Phone:516-432-2402
Mailing Address - Fax:
Practice Address - Street 1:109 MINEOLA AVE
Practice Address - Street 2:
Practice Address - City:POINT LOOKOUT
Practice Address - State:NY
Practice Address - Zip Code:11569-3023
Practice Address - Country:US
Practice Address - Phone:516-432-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645284-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse