Provider Demographics
NPI:1760764195
Name:MORRISON, CARRIE (PA-C)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3333 S BANNOCK ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2432
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:303-761-4252
Practice Address - Street 1:401 W HAMPDEN PL
Practice Address - Street 2:SUITE 250
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2470
Practice Address - Country:US
Practice Address - Phone:303-788-8989
Practice Address - Fax:303-788-8982
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92721257Medicaid
COCOAAA2123Medicare PIN