Provider Demographics
NPI:1609942838
Name:MORRIS, ELIZABETH MCCLOY (PNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MCCLOY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12950 HIGHLAND CROSSING DRIVE
Mailing Address - Street 2:STE. H
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171
Mailing Address - Country:US
Mailing Address - Phone:703-860-4200
Mailing Address - Fax:703-860-1528
Practice Address - Street 1:12950 HIGHLAND CROSSING DRIVE
Practice Address - Street 2:STE. H
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171
Practice Address - Country:US
Practice Address - Phone:703-860-4200
Practice Address - Fax:703-860-1528
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001150236363L00000X
VA0024164022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P30611Medicare UPIN