Provider Demographics
NPI:1063130995
Name:MURRAY, SHAWN ELLEN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:ELLEN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:SHAWN
Other - Middle Name:ELLEN
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4855 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2101
Mailing Address - Country:US
Mailing Address - Phone:914-552-2243
Mailing Address - Fax:
Practice Address - Street 1:4855 ACORN DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2101
Practice Address - Country:US
Practice Address - Phone:914-552-2243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021419363LF0000X
FL2022029844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily