Provider Demographics
NPI:1497488183
Name:MORRIS, TAYLOR MACKENZIE (PA-C)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MACKENZIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WILLIAMSON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3671
Mailing Address - Country:US
Mailing Address - Phone:083-558-8779
Mailing Address - Fax:908-355-0017
Practice Address - Street 1:240 WILLIAMSON ST STE 204
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3671
Practice Address - Country:US
Practice Address - Phone:908-355-8877
Practice Address - Fax:908-355-0017
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00712500363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical