Provider Demographics
NPI:1669183356
Name:MURRAY, AUTUMN ELAINE (PHARMD)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:ELAINE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:ELAINE
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3023 SUNMEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-3193
Mailing Address - Country:US
Mailing Address - Phone:260-715-8884
Mailing Address - Fax:
Practice Address - Street 1:900 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-9407
Practice Address - Country:US
Practice Address - Phone:260-715-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26030101A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist