Provider Demographics
NPI:1235121567
Name:MORRISON-METZ, DEBORAH (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MORRISON-METZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:YESOWITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-725-4505
Mailing Address - Fax:321-409-8932
Practice Address - Street 1:1223 GATEWAY DR STE 1E
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-725-4505
Practice Address - Fax:321-409-8932
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2992542207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307150200Medicaid