Provider Demographics
NPI:1013224534
Name:MORRIS, CONNIE JO (MSN, CRNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:JO
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 BISHOP WALSH RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1845
Mailing Address - Country:US
Mailing Address - Phone:301-759-3800
Mailing Address - Fax:301-777-7455
Practice Address - Street 1:925 BISHOP WALSH RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1845
Practice Address - Country:US
Practice Address - Phone:301-759-3800
Practice Address - Fax:301-777-7455
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN088399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4207751 00Medicaid