MEDICARE: MS. STEPHANIE KRISTINE MURRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1164267274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE KRISTINE MURRAY

Provider Business Mailing Address
First Line	:	11271 LOCKPORT CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2326
Country	:	US
Telephone Number	:	513-546-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 ELM ST STE 2701577
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2736
Country	:	US
Telephone Number	:	513-645-3704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

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