Provider Demographics
NPI:1528095668
Name:MORRIS, LINDA (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 W ALNA RD
Mailing Address - Street 2:
Mailing Address - City:ALNA
Mailing Address - State:ME
Mailing Address - Zip Code:04535-3410
Mailing Address - Country:US
Mailing Address - Phone:207-882-6555
Mailing Address - Fax:
Practice Address - Street 1:847 W ALNA RD
Practice Address - Street 2:
Practice Address - City:ALNA
Practice Address - State:ME
Practice Address - Zip Code:04535-3410
Practice Address - Country:US
Practice Address - Phone:207-882-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1471174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME7468198OtherAETNA
ME8142486OtherCIGNA
ME0278602913OtherCHAMPUS
ME060686OtherBLUE CROSS BLUE SHIELD
ME432131899Medicaid
ME432131899Medicaid