Provider Demographics
NPI:1043797228
Name:MORRIS, ALICIA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 19TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1528
Mailing Address - Country:US
Mailing Address - Phone:706-322-7884
Mailing Address - Fax:706-243-4356
Practice Address - Street 1:678 LEE ROAD 450
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36870
Practice Address - Country:US
Practice Address - Phone:706-332-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily