Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0024167702 | VA |
NPI | 1093986333 |
---|---|
Provider Name | Kelly M Murrer |
First Address | Newport News, VA 23606-4477 |
Second Address | Newport News, VA 23601-2548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 06/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093986333 | (05) | VA |