Healthcare Provider Details

I. General information

NPI: 1467374728
Provider Name (Legal Business Name): JOHN KYLE MURRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 BURGESSVILLE RD
RUSTON LA
71270-5154
US

IV. Provider business mailing address

1201 W CALIFORNIA AVE APT F22
RUSTON LA
71270-5576
US

V. Phone/Fax

Practice location:
  • Phone: 318-224-7223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: