MEDICARE: DOREEN W MURRAY APRN, CRNA

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	367500000X	Certified Registered Nurse Anesthetist	001710	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215950852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOREEN W MURRAY APRN, CRNA

Provider Business Mailing Address
First Line	:	3126 ANDORA DR
Second Line	:
City	:	SUPERIOR TOWNSHIP
State	:	MI
Zip	:	48198-9657
Country	:	US
Telephone Number	:	734-929-2945
Fax Number	:

Provider Business Practice Location Address
First Line	:	3126 ANDORA DR
Second Line	:
City	:	SUPERIOR TOWNSHIP
State	:	MI
Zip	:	48198-9657
Country	:	US
Telephone Number	:	734-929-2945
Fax Number	:

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/12/2009

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