Healthcare Provider Details

I. General information

NPI: 1598029241
Provider Name (Legal Business Name): LAUREN MURRELL HARRY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W 10TH ST OPW M200
INDIANAPOLIS IN
46202-2859
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-656-4260
  • Fax: 317-630-2667
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11016529A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: