1841844222 NPI number — AMARIS PATRICE MURRAY CRNP, FNP-C

Table of content: AMARIS PATRICE MURRAY CRNP, FNP-C (NPI 1841844222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841844222 NPI number — AMARIS PATRICE MURRAY CRNP, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURRAY
Provider First Name:
AMARIS
Provider Middle Name:
PATRICE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841844222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9501 BRANCHLEIGH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANDALLSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21133-2056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-683-6209
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 GARRISON BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21216-2309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-708-3958
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R205621 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP2300X , with the licence number: R205621 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 614115300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".