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General NPI Number Information
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NPI Number | 1417556127
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Entity Type | Individual
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Provider Name | VALEDA A MURRAY
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Gender | Female
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 2205 JACKSON CREEK RD
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City | COUNCIL
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State | ID
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Zip | 83612-5244
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Country | US
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Telephone | 208-812-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 2205 JACKSON CREEK RD
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City | COUNCIL
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State | ID
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Zip | 83612-5244
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Country | US
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Telephone | 208-812-2211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | 122
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License Number State | ID
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