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NPI Code Detail

MEDICARE: KELLY MURRAY CNM

MEDICARE: KELLY MURRAY CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerAPRN11004951FL
2367A00000XAdvanced Practice MidwifeAPRN11004951FL

General Provider Information

NPI Number : 1043247695
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY MURRAY CNM
Provider Business Mailing Address
First Line : PO BOX 748817
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8817
Country : US
Telephone Number : 813-286-0033
Fax Number : 813-282-1806
Provider Business Practice Location Address
First Line : 1600 DR MARTIN LUTHER KING JR ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33704-4204
Country : US
Telephone Number : 727-456-0750
Fax Number : 727-456-0751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 01/26/2024

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