Provider Demographics
NPI:1396134250
Name:MURRILL, LINDSEY (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MURRILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 KEAGY RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7458
Mailing Address - Country:US
Mailing Address - Phone:540-375-9375
Mailing Address - Fax:540-375-9376
Practice Address - Street 1:2850 KEAGY RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7458
Practice Address - Country:US
Practice Address - Phone:540-375-9375
Practice Address - Fax:540-375-9376
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-004839363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0110-004839OtherBOARD OF MEDICINE