Provider Demographics
NPI:1639757511
Name:MCMORRIS, TONYA LACORIA (RN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LACORIA
Last Name:MCMORRIS
Suffix:
Gender:F
Credentials:RN
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 88
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39043-0088
Mailing Address - Country:US
Mailing Address - Phone:601-824-1692
Mailing Address - Fax:
Practice Address - Street 1:725 BROOKMAN DR EXT
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2311
Practice Address - Country:US
Practice Address - Phone:601-823-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS915192163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health