Provider Demographics
NPI:1144653411
Name:MORRISSEY, ERIN MARIE (PA)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MARIE
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-0295
Mailing Address - Country:US
Mailing Address - Phone:660-665-7575
Mailing Address - Fax:660-665-7576
Practice Address - Street 1:1600 N MORLEY ST
Practice Address - Street 2:SUITE A120A
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-3666
Practice Address - Country:US
Practice Address - Phone:660-372-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3197363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical