Provider Demographics
NPI:1689953788
Name:MORRIS, SANDRA DENISE
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:DENISE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20571 ELLACOTT PKWY
Mailing Address - Street 2:APT 533
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4402
Mailing Address - Country:US
Mailing Address - Phone:216-799-1802
Mailing Address - Fax:
Practice Address - Street 1:20571 ELLACOTT PKWY
Practice Address - Street 2:APT 533
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-4402
Practice Address - Country:US
Practice Address - Phone:216-799-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.143024164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse