Provider Demographics
NPI:1558793703
Name:MORRIS, MAIRE (LPN)
Entity Type:Individual
Prefix:
First Name:MAIRE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BLACKSTONE LANDING DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-1706
Mailing Address - Country:US
Mailing Address - Phone:631-245-3178
Mailing Address - Fax:
Practice Address - Street 1:2101 BLACKSTONE LANDING DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-1706
Practice Address - Country:US
Practice Address - Phone:631-245-3178
Practice Address - Fax:866-500-2186
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5229984164W00000X
NY10304522164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse