Provider Demographics
NPI:1851993604
Name:MORRISON, VIVIAN R
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:R
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 KRISTINA CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4127
Mailing Address - Country:US
Mailing Address - Phone:937-371-5247
Mailing Address - Fax:
Practice Address - Street 1:353 KRISTINA CT
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-4127
Practice Address - Country:US
Practice Address - Phone:937-371-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5718557376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker