Healthcare Provider Details

I. General information

NPI: 1114849288
Provider Name (Legal Business Name): MRS. ASHLEY DAWN MURRAY MCRAE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S GILLETTE AVE STE B
GILLETTE WY
82716-3751
US

IV. Provider business mailing address

306 S GILLETTE AVE STE B
GILLETTE WY
82716-3751
US

V. Phone/Fax

Practice location:
  • Phone: 307-257-5053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPPC-1537
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: