Provider Demographics
NPI:1467419556
Name:MORRIS, CAROLANN MARY (RNPP)
Entity Type:Individual
Prefix:
First Name:CAROLANN
Middle Name:MARY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RNPP
Other - Prefix:
Other - First Name:CAROLANN
Other - Middle Name:MARY
Other - Last Name:HUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNPP
Mailing Address - Street 1:191 SOCIAL ST
Mailing Address - Street 2:THUNDERMIST HEALTH CENTER
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895
Mailing Address - Country:US
Mailing Address - Phone:401-767-4163
Mailing Address - Fax:401-767-4165
Practice Address - Street 1:2ND AVE SBHC
Practice Address - Street 2:THUNDERMIST HEALTH CENTER WOONSOCKET ELEMENTARY SCHOOL
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-767-4100
Practice Address - Fax:401-235-6894
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNNPP19813363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICM08877Medicaid
RICM08877Medicaid
RI07009640Medicare ID - Type Unspecified