1598750663 NPI number — JULIANNE RYAN MURRAY MSN

Table of content: JULIANNE RYAN MURRAY MSN (NPI 1598750663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598750663 NPI number — JULIANNE RYAN MURRAY MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURRAY
Provider First Name:
JULIANNE
Provider Middle Name:
RYAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RYAN
Provider Other First Name:
JULIANN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598750663
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10135 49TH AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55442-2527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-559-8771
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 NICOLLET MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55403-2530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-659-7111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2005

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:  R089687-4 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 368272200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".