Provider Demographics
NPI:1518921949
Name:MORRISON, HEIDI HAZELTON (ANP)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:HAZELTON
Last Name:MORRISON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 NEWHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4150
Mailing Address - Country:US
Mailing Address - Phone:440-796-6830
Mailing Address - Fax:
Practice Address - Street 1:6580 NEWHOUSE CT
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4150
Practice Address - Country:US
Practice Address - Phone:440-796-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP07403363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2453787Medicaid
OHQ00675Medicare UPIN
OH2453787Medicaid