Basic Information
Provider Information
NPI: 1215665930
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURRAY
FirstName: WENDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 11TH ST NW
Address2:  
City: CEDAR RAPIDS
State: IA
PostalCode: 524053811
CountryCode: US
TelephoneNumber: 3193983562
FaxNumber:  
Practice Location
Address1: 520 11TH ST NW
Address2:  
City: CEDAR RAPIDS
State: IA
PostalCode: 524053811
CountryCode: US
TelephoneNumber: 3193983562
FaxNumber: 3193983501
Other Information
ProviderEnumerationDate: 08/10/2022
LastUpdateDate: 10/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X142824IAN Nursing Service ProvidersRegistered Nurse 
363LP0808XG171612IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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