Provider Demographics
NPI:1922869734
Name:MURRAY, MADISON BROOKE
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:BROOKE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 MCCHESNEY DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3492
Mailing Address - Country:US
Mailing Address - Phone:276-608-5314
Mailing Address - Fax:
Practice Address - Street 1:550 MCCHESNEY DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3492
Practice Address - Country:US
Practice Address - Phone:276-608-5314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001310430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse