Provider Demographics
NPI:1790473494
Name:MORRIS, LAUREN ELIZABETH (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WONDERLAND DR APT 5C
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-3230
Mailing Address - Country:US
Mailing Address - Phone:910-220-3186
Mailing Address - Fax:
Practice Address - Street 1:100 WONDERLAND DR APT 5C
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-3230
Practice Address - Country:US
Practice Address - Phone:910-220-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260037822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000051315OtherBOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
VA0126003782OtherCOMMONWEALTH OF VIRGINIA BOARD OF MEDICINE