MEDICARE: SEAN DOYLE MURRY FNP-C

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	363LF0000X	Family Nurse Practitioner	238200	AZ

General Provider Information

NPI Number	:	1457222580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN DOYLE MURRY FNP-C

Provider Business Mailing Address
First Line	:	9816 E SUPERNOVA DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-1127
Country	:	US
Telephone Number	:	602-617-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	1655 W CHANDLER BLVD STE 104
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6284
Country	:	US
Telephone Number	:	602-617-1616
Fax Number	:

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

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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