Provider Demographics
NPI:1538666409
Name:MORRIS, MEGAN ELIZABETH (RN, CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:POORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:141 GROVE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1827
Mailing Address - Country:US
Mailing Address - Phone:310-741-0325
Mailing Address - Fax:
Practice Address - Street 1:148 W RIVER ST STE 8
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2615
Practice Address - Country:US
Practice Address - Phone:401-606-3000
Practice Address - Fax:401-331-8110
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2322668367A00000X
RICNM00171367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife