Provider Demographics
NPI:1467633743
Name:MURRAY, STACEY A (NP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:A
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9 PAYSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1309
Mailing Address - Country:US
Mailing Address - Phone:781-551-5812
Mailing Address - Fax:508-698-8671
Practice Address - Street 1:9 PAYSON RD STE 100
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035
Practice Address - Country:US
Practice Address - Phone:781-551-5812
Practice Address - Fax:508-698-8671
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN268193363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily