Healthcare Provider Details

I. General information

NPI: 1003751785
Provider Name (Legal Business Name): KIARA MURRY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 OAKLEY RD APT 1107
UNION CITY GA
30291-2445
US

IV. Provider business mailing address

6350 OAKLEY RD APT 1107
UNION CITY GA
30291-2445
US

V. Phone/Fax

Practice location:
  • Phone: 312-868-5854
  • Fax:
Mailing address:
  • Phone: 312-868-5854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP318003
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: