Healthcare Provider Details

I. General information

NPI: 1174600977
Provider Name (Legal Business Name): REBECCA MURRAY ERVIN RNC, WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W LYNDON B JOHNSON FWY PLAZA II, SUITE 405
IRVING TX
75063-3707
US

IV. Provider business mailing address

2014 SUNNYVALE RD
GRAND PRAIRIE TX
75050-1733
US

V. Phone/Fax

Practice location:
  • Phone: 972-869-0202
  • Fax: 972-432-9903
Mailing address:
  • Phone: 972-206-2359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number571738
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: