Provider Demographics
NPI:1740601723
Name:MORRIS, CLAUDETTE COLLENA
Entity Type:Individual
Prefix:MRS
First Name:CLAUDETTE
Middle Name:COLLENA
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 1:221-21 JAMAICA AVENUE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428
Mailing Address - Country:US
Mailing Address - Phone:718-468-6923
Mailing Address - Fax:718-468-6925
Practice Address - Street 1:221-21 JAMAICA AVENUE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428
Practice Address - Country:US
Practice Address - Phone:718-468-6923
Practice Address - Fax:718-468-6925
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271200164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse