Healthcare Provider Details

I. General information

NPI: 1619549037
Provider Name (Legal Business Name): MICHELLE MURRAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 04/12/2024
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 LANDA ST STE E
NEW BRAUNFELS TX
78130-6163
US

IV. Provider business mailing address

705 LANDA ST STE E
NEW BRAUNFELS TX
78130-6163
US

V. Phone/Fax

Practice location:
  • Phone: 210-360-1590
  • Fax:
Mailing address:
  • Phone: 210-360-1590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1036158
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: