Healthcare Provider Details

I. General information

NPI: 1942766456
Provider Name (Legal Business Name): MARIE MURRAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 FRIENDSHIP ST
NEWPORT RI
02840-2299
US

IV. Provider business mailing address

65 N PASTURE LN
WAKEFIELD RI
02879-7650
US

V. Phone/Fax

Practice location:
  • Phone: 401-846-6400
  • Fax:
Mailing address:
  • Phone: 401-793-1395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01855
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: