Provider Demographics
NPI:1578659165
Name:MORRIS, DIANE L (CNM NP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CNM NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 LEE GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522
Mailing Address - Country:US
Mailing Address - Phone:434-352-3559
Mailing Address - Fax:
Practice Address - Street 1:PIEDMONT HEALTH DISTRICT
Practice Address - Street 2:111 SOUTH STREET 1ST FLOOR
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901
Practice Address - Country:US
Practice Address - Phone:434-392-3984
Practice Address - Fax:434-392-1038
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001195218163W00000X
VA0024166792367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife