Provider Demographics
NPI:1295005007
Name:MORRIS, LYNETTE ELLEN (RD,CDE)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:ELLEN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-8976
Mailing Address - Country:US
Mailing Address - Phone:586-201-0869
Mailing Address - Fax:
Practice Address - Street 1:4369 BALDWIN RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8976
Practice Address - Country:US
Practice Address - Phone:586-201-0869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal