Individual provider Active NPI

Jennifer Lynn Murray, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Pleasant Prairie, WI
National Provider Identifier
1245871425
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
969033 Issued in WI
Practice address
10256 Old Green Bay Rd
Pleasant Prairie, WI 53158-2814
Phone
(262) 551-4200
Fax
(262) 551-4947
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041413649 IL
Registered Nurse 163W00000X 24062930 WI
Family Nurse Practitioner 363LF0000X 209020321 IL
Family Nurse Practitioner 363LF0000X 969033 WI Primary

Addresses

Primary practice location

10256 Old Green Bay Rd
Pleasant Prairie, WI 53158-2814

Mailing address

10256 Old Green Bay Rd
Pleasant Prairie, WI 53158-2814
Phone (262) 551-4200

Other identifiers 2

IdentifierTypeStateIssuer
1245871425MedicaidWI
9690-33OtherWIWI APNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
041413649ILMDRegistered Nurse
24062930WIMDRegistered Nurse
209020321ILMDFamily Nurse Practitioner
969033WIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1245871425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10256 OLD GREEN BAY RD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582814",
            "telephone_number": "262-551-4200",
            "fax_number": "262-551-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10256 OLD GREEN BAY RD",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582814",
            "telephone_number": "262-551-4200",
            "fax_number": "262-551-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041413649",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "24062930",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020321",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "969033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245871425",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI APNP LICENSE",
            "identifier": "9690-33",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.