Provider Demographics
NPI:1033163472
Name:MORRISEY, YVONNE J (OD)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:J
Last Name:MORRISEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 MONTEBELLO RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1236
Mailing Address - Country:US
Mailing Address - Phone:719-545-1530
Mailing Address - Fax:719-545-2899
Practice Address - Street 1:1145 OHIO AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2278
Practice Address - Country:US
Practice Address - Phone:719-275-7481
Practice Address - Fax:719-275-0059
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2021152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO608439600OtherUS DEPT OF LABOR WORK COM
CO1984880OtherUNITED HEALTHCARE
CO92008310884OtherEYE SPECIALISTS
COP00314904OtherRAILROAD MEDICARE
CO0452890001OtherMEDICARE DMERC
CO38103273Medicaid
CO952791OtherEYEMED EYE
COMOY64360OtherANTHEM
COMOY64360OtherANTHEM
CO952791OtherEYEMED EYE