Provider Demographics
NPI:1821214115
Name:MORSE, AMY SYDELL (RN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SYDELL
Last Name:MORSE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:CAROLYN
Other - Last Name:SYDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CPNP
Mailing Address - Street 1:134 ELON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-2536
Mailing Address - Country:US
Mailing Address - Phone:434-455-2480
Mailing Address - Fax:434-455-2487
Practice Address - Street 1:407 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-2459
Practice Address - Country:US
Practice Address - Phone:434-200-6401
Practice Address - Fax:434-455-2487
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700680363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner