Provider Demographics
NPI:1902232838
Name:MURRAY, EVELYN JANE WATSON (NP-C)
Entity Type:Individual
Prefix:MS
First Name:EVELYN JANE
Middle Name:WATSON
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:EVELYN JANE
Other - Middle Name:WATSON
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5182 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632
Mailing Address - Country:US
Mailing Address - Phone:229-412-1972
Mailing Address - Fax:229-375-0758
Practice Address - Street 1:2410 BEMISS RD STE C
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:229-216-8604
Practice Address - Fax:229-375-0758
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN102687363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner