Provider Demographics
NPI:1710570791
Name:MORRIS, HOLDEN MICHAEL
Entity Type:Individual
Prefix:
First Name:HOLDEN
Middle Name:MICHAEL
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 1:9622 E ELMWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-5331
Mailing Address - Country:US
Mailing Address - Phone:602-668-7015
Mailing Address - Fax:
Practice Address - Street 1:9622 E ELMWOOD ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-5331
Practice Address - Country:US
Practice Address - Phone:602-668-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health