Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0001279214 | VA |
NPI | 1023426491 |
---|---|
Provider Name | Jessica Murray |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2014 |
Last Update Date | 29/07/2021 |