Provider Demographics
NPI:1659748564
Name:MORRISON, AMBER (FNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MORRISON
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 1:17150 BRANNAN FORK RD
Mailing Address - Street 2:
Mailing Address - City:CITRONELLE
Mailing Address - State:AL
Mailing Address - Zip Code:36522-2705
Mailing Address - Country:US
Mailing Address - Phone:817-896-6944
Mailing Address - Fax:
Practice Address - Street 1:251 N BAYOU ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603-5827
Practice Address - Country:US
Practice Address - Phone:251-690-8847
Practice Address - Fax:251-690-8859
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT99241363L00000X, 363LF0000X
AL1-154392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630000013OtherGROUP MEDICAID PAYEE NUMBER
AL1063439065OtherNPI MAIN GROUP PAYEE NUMBER
AL011846Medicare PIN