Provider Demographics
NPI:1447673447
Name:MCMURRAY, JENNIFER L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:MCMURRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:CLUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6023 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3053
Mailing Address - Country:US
Mailing Address - Phone:412-661-2802
Mailing Address - Fax:412-661-8020
Practice Address - Street 1:6023 HARVARD ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3053
Practice Address - Country:US
Practice Address - Phone:412-661-2802
Practice Address - Fax:412-661-8020
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003892363A00000X
PAMA061464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0101598Medicaid