Provider Demographics
NPI:1831557263
Name:MORSE, JILLIAN BROOKE (CRNA)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:BROOKE
Last Name:MORSE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2764 FOUNTAIN VIEW CIR
Mailing Address - Street 2:APARTMENT 107
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2725
Mailing Address - Country:US
Mailing Address - Phone:810-241-8299
Mailing Address - Fax:
Practice Address - Street 1:550 W WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1045
Practice Address - Country:US
Practice Address - Phone:231-726-4498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-30
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704249072367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered