Healthcare Provider Details

I. General information

NPI: 1164094496
Provider Name (Legal Business Name): MATTHEW JOSEPH MURRAY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 WEST ST
MANSFIELD MA
02048-1035
US

IV. Provider business mailing address

1601 WEST ST
MANSFIELD MA
02048-1035
US

V. Phone/Fax

Practice location:
  • Phone: 774-219-1829
  • Fax:
Mailing address:
  • Phone: 774-219-1829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2351246
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: