Provider Demographics
NPI:1255656286
Name:MORRIS, VICKIE JEAN (LPN)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:JEAN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WOODBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-7654
Mailing Address - Country:US
Mailing Address - Phone:740-624-4937
Mailing Address - Fax:
Practice Address - Street 1:3100 WOODBERRY DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7654
Practice Address - Country:US
Practice Address - Phone:740-624-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.066341164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse