=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972565588
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDITH ANN MURRAY APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 975 E 3RD ST BOX 159
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-2103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-778-6170
-----------------------------------------------------
Fax | 423-778-6938
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 754 GRAND MOUNTAIN DR
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37421-7428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-893-6833
-----------------------------------------------------
Fax | 423-893-6977
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LN0000X
-----------------------------------------------------
Taxonomy Name | Neonatal Nurse Practitioner
-----------------------------------------------------
License Number | APN6243
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------