Provider Demographics
NPI:1538784590
Name:MURRAY, COLEEN LOUISE (RN)
Entity type:Individual
Prefix:
First Name:COLEEN
Middle Name:LOUISE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:COLEEN
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 PINTAIL CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2770
Mailing Address - Country:US
Mailing Address - Phone:304-281-3200
Mailing Address - Fax:
Practice Address - Street 1:1421 BLUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4809
Practice Address - Country:US
Practice Address - Phone:803-733-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90182163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse