Provider Demographics
NPI:1992787279
Name:MURRAY, ANN M (PA-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:MURRAY-BRAAFHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:5201 N 19TH AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-2901
Mailing Address - Country:US
Mailing Address - Phone:602-301-7947
Mailing Address - Fax:602-354-5281
Practice Address - Street 1:5201 N 19TH AVE STE 121
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2901
Practice Address - Country:US
Practice Address - Phone:602-301-7947
Practice Address - Fax:602-354-5281
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2128363AM0700X
AZ2870363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical