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General NPI Number Information
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NPI Number | 1023289865
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Entity Type | Organization
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Legal Business Name | MURRAY MOUNTAIN MEDICAL CENTER
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 79 HWY 286 SUITE B
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City | ETON
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State | GA
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Zip | 30724
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Country | US
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Telephone | 706-695-1992
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1007
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City | ETON
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State | GA
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Zip | 30724-1007
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Country | US
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Telephone | 706-695-1992
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHANNON JINRIGHT
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Credential |
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Telephone | 706-695-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN149515
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License Number State | GA
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