Provider Demographics
NPI:1467040550
Name:MORRIS, JIMMIE L (RP)
Entity Type:Individual
Prefix:
First Name:JIMMIE
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 Q ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-1118
Mailing Address - Country:US
Mailing Address - Phone:402-694-3187
Mailing Address - Fax:
Practice Address - Street 1:219 Q ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-1118
Practice Address - Country:US
Practice Address - Phone:402-694-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist