Provider Demographics
NPI:1639743560
Name:MURR, MEGAN LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:MURR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CLINIC RD
Mailing Address - Street 2:
Mailing Address - City:TATE
Mailing Address - State:GA
Mailing Address - Zip Code:30177-2588
Mailing Address - Country:US
Mailing Address - Phone:678-454-3331
Mailing Address - Fax:678-454-3332
Practice Address - Street 1:88 CLINIC RD
Practice Address - Street 2:
Practice Address - City:TATE
Practice Address - State:GA
Practice Address - Zip Code:30177-2588
Practice Address - Country:US
Practice Address - Phone:678-454-3331
Practice Address - Fax:678-454-3332
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28142960A163WM0705X
FL11016004363LF0000X
GAGAA-NP003773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF05210167Medicaid