Provider Demographics
NPI:1841981438
Name:MURRAY, AMANDA LEANNE (DNP)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEANNE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 W 2225 S
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9104
Mailing Address - Country:US
Mailing Address - Phone:714-423-5049
Mailing Address - Fax:
Practice Address - Street 1:572 W 2225 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9104
Practice Address - Country:US
Practice Address - Phone:714-423-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11371754-3102163W00000X
UT11371754-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse