Provider Demographics
NPI:1417404831
Name:MORRISON, MISTY ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:MISTY
Middle Name:ANN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RN
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 243
Mailing Address - Street 2:129 MAPLE STREET
Mailing Address - City:FRAZEYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43822-0243
Mailing Address - Country:US
Mailing Address - Phone:740-319-9931
Mailing Address - Fax:
Practice Address - Street 1:129 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FRAZEYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43822-9553
Practice Address - Country:US
Practice Address - Phone:740-319-9931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 279297163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN 279297OtherOHIO BOARD OF NURSING