Healthcare Provider Details

I. General information

NPI: 1760629018
Provider Name (Legal Business Name): KIMBERLY ANNE MURRAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 NORTHCREEK DR STE 1400
CINCINNATI OH
45236-2379
US

IV. Provider business mailing address

8240 NORTHCREEK DR STE 1400
CINCINNATI OH
45236-2379
US

V. Phone/Fax

Practice location:
  • Phone: 513-792-4700
  • Fax: 513-346-1396
Mailing address:
  • Phone: 513-792-4700
  • Fax: 513-346-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number50.002866
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.002866RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: