Provider Demographics
NPI:1619512951
Name:MORRIS, JANA REBECCA
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:REBECCA
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:GANS
Mailing Address - State:OK
Mailing Address - Zip Code:74936-0333
Mailing Address - Country:US
Mailing Address - Phone:918-776-7407
Mailing Address - Fax:
Practice Address - Street 1:467055 E 1120 RD
Practice Address - Street 2:
Practice Address - City:GANS
Practice Address - State:OK
Practice Address - Zip Code:74936-5016
Practice Address - Country:US
Practice Address - Phone:918-776-7407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator