Provider Demographics
NPI:1023056207
Name:MORRIS, BODIL LYNN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:BODIL
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 CARROLL AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6386
Mailing Address - Country:US
Mailing Address - Phone:301-891-6100
Mailing Address - Fax:301-891-5836
Practice Address - Street 1:13801 BELLE CHASSE BLVD
Practice Address - Street 2:UNIT 211
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6386
Practice Address - Country:US
Practice Address - Phone:407-232-5062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR081714363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY063KOtherBCBS
FL306796300Medicaid
P67566Medicare UPIN
FL306796300Medicaid