Provider Demographics
NPI:1306398649
Name:MORRISON, JESSICA M (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:MORRISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W CANAL ST
Mailing Address - Street 2:SUITE C1
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 W CANAL ST
Practice Address - Street 2:SUITE C1
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2131
Practice Address - Country:US
Practice Address - Phone:802-654-3562
Practice Address - Fax:802-654-3698
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0119617363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health