Provider Demographics
NPI:1245298918
Name:MURRAY, DONNA L (LICENSED PRACTICAL N)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11594 CO HWY 18
Mailing Address - Street 2:
Mailing Address - City:ULEN
Mailing Address - State:MN
Mailing Address - Zip Code:56585
Mailing Address - Country:US
Mailing Address - Phone:218-596-8361
Mailing Address - Fax:
Practice Address - Street 1:40520 CO HWY 34
Practice Address - Street 2:WHITE EARTH HEALTH CENTER
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569
Practice Address - Country:US
Practice Address - Phone:218-983-4300
Practice Address - Fax:218-983-6217
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL0451811164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse