Provider Demographics
NPI:1144631797
Name:OSTER-MORRIS, ELIJAH (PMHNP)
Entity type:Individual
Prefix:MR
First Name:ELIJAH
Middle Name:
Last Name:OSTER-MORRIS
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3160
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:312
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-977-1582
Practice Address - Fax:520-844-1058
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5553363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health