Provider Demographics
NPI:1861688319
Name:MURRAY, JENNIFER (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 S ROCKFORD DR STE 220
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-6226
Mailing Address - Country:US
Mailing Address - Phone:480-892-8400
Mailing Address - Fax:602-508-4830
Practice Address - Street 1:2030 S SOLANO DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5402
Practice Address - Country:US
Practice Address - Phone:575-521-1158
Practice Address - Fax:575-521-1007
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOPT582152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM63225778Medicaid