Provider Demographics
NPI:1487902417
Name:MORRIS, MICHELLE DENISE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DENISE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 OHIO AVE S
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-4514
Mailing Address - Country:US
Mailing Address - Phone:386-219-4060
Mailing Address - Fax:386-245-7100
Practice Address - Street 1:1520 OHIO AVE S
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-4514
Practice Address - Country:US
Practice Address - Phone:386-219-4060
Practice Address - Fax:386-245-7100
Is Sole Proprietor?:No
Enumeration Date:2012-08-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9173028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily