Provider Demographics
NPI:1093753980
Name:MORRIS, LORI MAXINE (CRNA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:MAXINE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 JEFFORDS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3810
Mailing Address - Country:US
Mailing Address - Phone:727-441-1524
Mailing Address - Fax:
Practice Address - Street 1:300 JEFFORDS ST
Practice Address - Street 2:SUITE B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3810
Practice Address - Country:US
Practice Address - Phone:727-441-1524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99511367500000X
FLARNP9262097367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308625900Medicaid
TN4117246OtherBLUE CROSS
TN4117246OtherBLUECARE
TNP00275288OtherMEDICARE TRAVELERS
FLG4379OtherBCBS
TN100049033OtherPHP TENNCARE
TN3635500Medicaid
TN100049033OtherPHP TENNCARE
TN3635500Medicaid