Provider Demographics
NPI:1902579196
Name:MORRIS, TAMMY ANN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 STATE ST STE 4-1
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2683
Mailing Address - Country:US
Mailing Address - Phone:207-760-7148
Mailing Address - Fax:207-554-5155
Practice Address - Street 1:187 STATE ST STE 4-1
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2683
Practice Address - Country:US
Practice Address - Phone:207-760-7148
Practice Address - Fax:207-554-5155
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN79645163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health