MEDICARE: KELLY W MURAKATA AGNP-BC

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	363LA2200X	Adult Health Nurse Practitioner	26NJ00607000	NJ
2	363LG0600X	Gerontology Nurse Practitioner	26NJ00607000	NJ
3	363LP2300X	Primary Care Nurse Practitioner	26NJ00607000	NJ

General Provider Information

NPI Number	:	1992076640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY W MURAKATA AGNP-BC

Provider Business Mailing Address
First Line	:	18 VICTOR AVE
Second Line	:
City	:	EATONTOWN
State	:	NJ
Zip	:	07724-1321
Country	:	US
Telephone Number	:	732-337-0220
Fax Number	:	732-389-0562

Provider Business Practice Location Address
First Line	:	28 VALLEY RD # 148
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2709
Country	:	US
Telephone Number	:	201-273-7047
Fax Number	:	609-998-4358

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

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	07/18/2025

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