Provider Demographics
NPI:1619012846
Name:MORRIS, PAULA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 U S HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8569
Mailing Address - Country:US
Mailing Address - Phone:601-268-9393
Mailing Address - Fax:601-268-9559
Practice Address - Street 1:39 FRANKLIN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1588
Practice Address - Country:US
Practice Address - Phone:601-268-9393
Practice Address - Fax:601-268-9559
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR853775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I503271OtherMEDICARE PTAN
MS01339813Medicaid