Provider Demographics
NPI:1699176412
Name:MORRIS, DAWN (FNP-C)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8174 S. KIPLING PKWY #190
Mailing Address - Street 2:C/O PHENIX SALON SUITE 119
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6320
Mailing Address - Country:US
Mailing Address - Phone:720-471-7017
Mailing Address - Fax:
Practice Address - Street 1:8174 S. KIPLING PKWY #190
Practice Address - Street 2:C/O PHENIX SALON SUITE 119
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6320
Practice Address - Country:US
Practice Address - Phone:720-471-7017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991292-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
13588700OtherCAQH PROVIDER ID
CO58482539Medicaid
CO400939YUXKMedicare PIN