Provider Demographics
NPI:1467493908
Name:MORRIS, PATRICIA K (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:K
Last Name:MORRIS
Suffix:
Gender:F
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 711841
Mailing Address - Street 2:MID- ATLANTIC ANESTHESIA CONSULTANTS
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-0001
Mailing Address - Country:US
Mailing Address - Phone:304-346-9400
Mailing Address - Fax:304-345-7320
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3494
Practice Address - Country:US
Practice Address - Phone:304-598-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17632367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001706470OtherMSBCBS GROUP
WV0065481000Medicaid
WV270052997004OtherTRICARE
WV27005299701OtherBRICKSTREET
WVWORKERS COMPOther27005299700
WV001720738OtherMOUNTAIN STATE BCBS
WV1005755OtherBRICKSTREET INDIVIDUAL
WVP00142893OtherRR MEDICARE
WV0207026000Medicaid
WV27005299700OtherWORKERS COMP
WV27005299701OtherWORKERS COMP
WVDA0096OtherRR MEDICARE
WV27005299701OtherWORKERS COMP
WV8232744Medicare PIN