Provider Demographics
NPI:1396086245
Name:MURRAY, COLLEEN S (CNP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:S
Last Name:MURRAY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401S DON ROSER DR F1-2
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4567
Mailing Address - Country:US
Mailing Address - Phone:575-521-4848
Mailing Address - Fax:575-522-1798
Practice Address - Street 1:1626 MEDICAL CENTER DR
Practice Address - Street 2:STE 503
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5010
Practice Address - Country:US
Practice Address - Phone:915-532-3770
Practice Address - Fax:915-313-0487
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692262363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOther692262
TX692262Other692262