Provider Demographics
NPI:1629306709
Name:MORRIS, AUTUMN BRIANNE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:BRIANNE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CPNP-PC
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:817-885-1855
Mailing Address - Fax:
Practice Address - Street 1:1500 W ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7403
Practice Address - Country:US
Practice Address - Phone:682-885-3426
Practice Address - Fax:682-885-7699
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP118426363LP2300X, 363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics