Provider Demographics
NPI:1699399907
Name:MORRIS, NATHAN MATTHEW
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:MATTHEW
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 N CHURCH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-6590
Mailing Address - Country:US
Mailing Address - Phone:801-771-7771
Mailing Address - Fax:833-643-2775
Practice Address - Street 1:96 E KIMBALLS LN STE 202
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5021
Practice Address - Country:US
Practice Address - Phone:801-523-3053
Practice Address - Fax:801-523-3059
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty