Provider Demographics
NPI:1497238299
Name:MORRIS, TASHA CHARLENE (CRNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:CHARLENE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:CHARLENE
Other - Last Name:LEIBENSPERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2036
Mailing Address - Country:US
Mailing Address - Phone:215-206-2980
Mailing Address - Fax:
Practice Address - Street 1:1400 BLACKHORSE HILL RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2040
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019222363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health