Provider Demographics
NPI:1619993458
Name:MCMORRAN, ELIZABETH A (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MCMORRAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 E WARNER RD STE 127
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3057
Mailing Address - Country:US
Mailing Address - Phone:480-632-5800
Mailing Address - Fax:480-545-2870
Practice Address - Street 1:690 E WARNER RD STE 127
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3057
Practice Address - Country:US
Practice Address - Phone:480-632-5800
Practice Address - Fax:480-545-2870
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2312363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ11630909OtherCAQH
AZ116492Medicaid