Provider Demographics
NPI:1518238054
Name:MORRIS, GRACE
Entity Type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 TAHOE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1467
Mailing Address - Country:US
Mailing Address - Phone:651-387-3944
Mailing Address - Fax:
Practice Address - Street 1:445 MINNESOTA ST
Practice Address - Street 2:SUITE 1500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2190
Practice Address - Country:US
Practice Address - Phone:651-387-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-14
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator