Provider Demographics
NPI:1073189874
Name:MORRIS, JACQUELINE HELENE (RN)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:HELENE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-6413
Mailing Address - Country:US
Mailing Address - Phone:810-777-1930
Mailing Address - Fax:
Practice Address - Street 1:2613 PIERCE ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-6413
Practice Address - Country:US
Practice Address - Phone:810-777-1930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704173977163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health