Basic Information
| Provider Information | |||||||||
| NPI: | 1861500373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURRAY | ||||||||
| FirstName: | IRENE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 578 BALDWINVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BALDWINVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014361351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789391249 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 45 SUMMER ST | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785346116 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 146144 | MA | X | Nursing Service Providers | Registered Nurse | 163WP0808X | 146144 | MA | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.