Provider Demographics
NPI:1922033323
Name:MORRIS, ADDIE MARIE (APRN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 CYPRESS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5468
Mailing Address - Country:US
Mailing Address - Phone:318-388-5030
Mailing Address - Fax:318-388-7134
Practice Address - Street 1:2933 CYPRESS ST STE 1
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-388-5030
Practice Address - Fax:318-388-7134
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1508951Medicaid