Provider Demographics
NPI:1326739681
Name:MORRIS, TENEEA SHAREESE (AGACNP)
Entity Type:Individual
Prefix:
First Name:TENEEA
Middle Name:SHAREESE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:MRS
Other - First Name:TENEEA
Other - Middle Name:SHAREESE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TENEEA MORRIS AGACNP
Mailing Address - Street 1:1 FORD PL STE 3A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2333 BIDDLE AVE
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4668
Practice Address - Country:US
Practice Address - Phone:313-916-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704322731363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care