Provider Demographics
NPI:1457075905
Name:MURMANN, GREGORY JAMES (MSN, RN)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JAMES
Last Name:MURMANN
Suffix:
Gender:M
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11153 WINDING BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-1555
Mailing Address - Country:US
Mailing Address - Phone:216-294-8292
Mailing Address - Fax:
Practice Address - Street 1:11153 WINDING BROOK LN
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-1555
Practice Address - Country:US
Practice Address - Phone:216-294-8292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.306084163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.306084Medicaid