Provider Demographics
NPI:1326232406
Name:MORRISON, JENNIFER M (APN/CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:MORRISON
Suffix:
Gender:F
Credentials:APN/CNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:SCHMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN/CNP
Mailing Address - Street 1:4050 HEALTHWAY DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504
Mailing Address - Country:US
Mailing Address - Phone:630-318-3355
Mailing Address - Fax:
Practice Address - Street 1:4050 HEALTHWAY DR
Practice Address - Street 2:SUITE 140
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-318-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041333254363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041333254OtherRN LICENSE
IL041333254OtherRN LICENSE
ILD12466Medicare UPIN
IL$$$$$$$$$001Medicaid