Provider Demographics
NPI:1255925327
Name:MURRAY, NIKOLE (NP)
Entity type:Individual
Prefix:
First Name:NIKOLE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 THOMAS JOHNSON DR STE 209
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4490
Mailing Address - Country:US
Mailing Address - Phone:301-662-6755
Mailing Address - Fax:
Practice Address - Street 1:45 THOMAS JOHNSON DR STE 209
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4490
Practice Address - Country:US
Practice Address - Phone:301-662-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210013363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health