Provider Demographics
NPI:1114354636
Name:MORRIS, SHAYNE O'NEAL (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:SHAYNE
Middle Name:O'NEAL
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 GREENBRIER CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2640
Mailing Address - Country:US
Mailing Address - Phone:757-547-9007
Mailing Address - Fax:
Practice Address - Street 1:860 GREENBRIER CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2640
Practice Address - Country:US
Practice Address - Phone:757-547-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171163363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health