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NPI Code Detail

MEDICARE: DR. JACQUELYN V MURRAY NP, ND

MEDICARE:  DR. JACQUELYN V MURRAY  NP, ND
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
1363LA2200XAdult Health Nurse Practitioner4216CO
2363LA2200XAdult Health Nurse Practitioner738HI
3364SA2200XAdult Health Clinical Nurse Specialist3542CO

General Provider Information

NPI Number : 1750479259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELYN V MURRAY NP, ND
Provider Business Mailing Address
First Line : 75-6119 HOOMAMA ST
Second Line :
City : KAILUA KONA
State : HI
Zip : 96740-7953
Country : US
Telephone Number : 808-326-9755
Fax Number :
Provider Business Practice Location Address
First Line : 75-166 KALANI ST
Second Line :
City : KAILUA KONA
State : HI
Zip : 96740-1857
Country : US
Telephone Number : 808-329-9740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 03/03/2008

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