Provider Demographics
NPI:1942701172
Name:MORRIS, GLENDA FAYE
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:FAYE
Last Name:MORRIS
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 1:5011 WHISPER WIND DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-3075
Mailing Address - Country:US
Mailing Address - Phone:940-781-3117
Mailing Address - Fax:
Practice Address - Street 1:5011 WHISPER WIND DR
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-3075
Practice Address - Country:US
Practice Address - Phone:940-781-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219954164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse