Healthcare Provider Details

I. General information

NPI: 1093374480
Provider Name (Legal Business Name): MACKENZIE CHRISTINE MURRAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 YORK RD STE 305
TOWSON MD
21204-7449
US

IV. Provider business mailing address

7801 YORK RD STE 305
TOWSON MD
21204-7449
US

V. Phone/Fax

Practice location:
  • Phone: 410-583-5677
  • Fax:
Mailing address:
  • Phone: 410-583-5677
  • Fax: 410-583-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0008876
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA004867
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: