Provider Demographics
NPI:1396814620
Name:MORRIS, JOHN (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37116-0488
Mailing Address - Country:US
Mailing Address - Phone:615-865-6268
Mailing Address - Fax:615-868-7378
Practice Address - Street 1:154 CUDE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2202
Practice Address - Country:US
Practice Address - Phone:615-865-6268
Practice Address - Fax:615-868-7378
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40288367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3607184Medicaid
3607184Medicare ID - Type Unspecified