Provider Demographics
NPI:1760405906
Name:MORREN-MORRISON, EDITH (APRN)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:MORREN-MORRISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2348
Mailing Address - Country:US
Mailing Address - Phone:203-752-2856
Mailing Address - Fax:203-752-8785
Practice Address - Street 1:45 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-5920
Practice Address - Country:US
Practice Address - Phone:860-443-4575
Practice Address - Fax:860-447-3177
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000025363LF0000X
CT0000025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500001099Medicare ID - Type Unspecified
CTP02844Medicare UPIN
CT500001171Medicare PIN