Healthcare Provider Details

I. General information

NPI: 1912279704
Provider Name (Legal Business Name): PATRICIA L. MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD STE 130
LAS VEGAS NV
89104-6681
US

IV. Provider business mailing address

8435 SEQUOIA GROVE AVE
LAS VEGAS NV
89149-0253
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-4000
  • Fax: 702-968-4040
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number70571
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: