Provider Demographics
NPI:1861768244
Name:MURRAY, LINDA (CRNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:LAKE WINOLA
Mailing Address - State:PA
Mailing Address - Zip Code:18625-0489
Mailing Address - Country:US
Mailing Address - Phone:570-378-3047
Mailing Address - Fax:570-378-3418
Practice Address - Street 1:1240 ROUTE 307
Practice Address - Street 2:
Practice Address - City:LAKE WINOLA
Practice Address - State:PA
Practice Address - Zip Code:18625-0489
Practice Address - Country:US
Practice Address - Phone:570-378-3047
Practice Address - Fax:570-378-3418
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP001205K364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health