Healthcare Provider Details

I. General information

NPI: 1821533217
Provider Name (Legal Business Name): JACQUELINE L MURRAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WASHINGTON AVE FL 1A
HAMDEN CT
06518-3267
US

IV. Provider business mailing address

2 BARNES INDUSTRIAL RD S
WALLINGFORD CT
06492-2486
US

V. Phone/Fax

Practice location:
  • Phone: 203-865-6784
  • Fax: 203-865-6788
Mailing address:
  • Phone: 203-626-0160
  • Fax: 203-294-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number6798
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number6798
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: