Healthcare Provider Details

I. General information

NPI: 1649909706
Provider Name (Legal Business Name): JAMIE MURRAY CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 NW SOUTH OUTER RD
BLUE SPRINGS MO
64015-2963
US

IV. Provider business mailing address

2716 SW CARLTON DR
LEES SUMMIT MO
64082-1448
US

V. Phone/Fax

Practice location:
  • Phone: 816-524-5600
  • Fax:
Mailing address:
  • Phone: 816-363-9664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2022022176
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2005011451
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: