Provider Demographics
NPI:1609862804
Name:MORRISON, JAMIE S (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:S
Last Name:MORRISON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5717 CLOVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4746
Mailing Address - Country:US
Mailing Address - Phone:615-500-6466
Mailing Address - Fax:
Practice Address - Street 1:5717 CLOVERWOOD DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4746
Practice Address - Country:US
Practice Address - Phone:615-500-6466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN071185367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74008038Medicaid
AL009939335Medicaid
TN3635115Medicaid
TN4072320OtherBCBS NUMBER
TN3635115Medicaid