Provider Demographics
NPI:1770028854
Name:MURRAY, ASHLEY (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 E LONGSHORE PL
Mailing Address - Street 2:
Mailing Address - City:PEORIA HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:61616-4430
Mailing Address - Country:US
Mailing Address - Phone:309-201-1167
Mailing Address - Fax:
Practice Address - Street 1:2002 E LONGSHORE PL
Practice Address - Street 2:
Practice Address - City:PEORIA HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:61616-4430
Practice Address - Country:US
Practice Address - Phone:309-201-1167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043111278164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse