Basic Information
Provider Information | |||||||||
NPI: | 1639396401 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCMURRAY | ||||||||
FirstName: | SUSAN | ||||||||
MiddleName: | M | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | R.N. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MCMURRAY | ||||||||
OtherFirstName: | SUSAN | ||||||||
OtherMiddleName: | G | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 1040 OLD LN | ||||||||
Address2: |   | ||||||||
City: | DREXEL HILL | ||||||||
State: | PA | ||||||||
PostalCode: | 190261920 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6104765840 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 400 E MARSHALL ST | ||||||||
Address2: |   | ||||||||
City: | WEST CHESTER | ||||||||
State: | PA | ||||||||
PostalCode: | 193805412 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4848260400 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/20/2007 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN249204L | PA | Y |   | Nursing Service Providers | Registered Nurse |   |
No ID Information.