Provider Demographics
NPI:1245214485
Name:MORRIS, STEVEN J (CRNA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 THOMAS JOHNSON DR STE 215
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4527
Mailing Address - Country:US
Mailing Address - Phone:301-668-9988
Mailing Address - Fax:
Practice Address - Street 1:196 THOMAS JOHNSON DR STE 215
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4527
Practice Address - Country:US
Practice Address - Phone:301-668-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR87119367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2991Medicaid
SC1152OtherMEDICARE - GROUP
SC400097OtherMEDICAID - GROUP
SCAN1064Medicaid
SC6877Medicare ID - Type UnspecifiedGROUP
SCAN1064Medicaid