Provider Demographics
NPI:1851729255
Name:MORRISON, TASHABA ANN (RN)
Entity Type:Individual
Prefix:
First Name:TASHABA
Middle Name:ANN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 SQUIRE DALE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3127
Mailing Address - Country:US
Mailing Address - Phone:585-503-8599
Mailing Address - Fax:
Practice Address - Street 1:295 SQUIRE DALE LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3127
Practice Address - Country:US
Practice Address - Phone:585-503-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000679126800000X
NY316680164W00000X
NY875677163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No126800000XDental ProvidersDental Assistant
No164W00000XNursing Service ProvidersLicensed Practical Nurse