Provider Demographics
NPI:1174248389
Name:MURRAY, KAMERON JOSEPH (MSPAS)
Entity type:Individual
Prefix:
First Name:KAMERON
Middle Name:JOSEPH
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 SPALDING DR
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1033
Mailing Address - Country:US
Mailing Address - Phone:314-616-6168
Mailing Address - Fax:
Practice Address - Street 1:1315 TIBBALS ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1257
Practice Address - Country:US
Practice Address - Phone:308-995-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA