Provider Demographics
NPI:1922290550
Name:MORRIS, MICHELE RENEE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:RENEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:RENEE
Other - Last Name:KERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4100 W 3RD ST
Mailing Address - Street 2:OUTPATIENT PHARMACY
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45428-9000
Mailing Address - Country:US
Mailing Address - Phone:937-268-6511
Mailing Address - Fax:
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:OUTPATIENT PHARMACY
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-19490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist