Provider Demographics
NPI:1679944144
Name:MORRIS, TINA SUZANNE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:SUZANNE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 DRAWHORN RD
Mailing Address - Street 2:
Mailing Address - City:BRONSON
Mailing Address - State:TX
Mailing Address - Zip Code:75930-5304
Mailing Address - Country:US
Mailing Address - Phone:936-275-8681
Mailing Address - Fax:
Practice Address - Street 1:315 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4013
Practice Address - Country:US
Practice Address - Phone:409-384-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily