Provider Demographics
NPI:1184883027
Name:MORRISON, LUANN RENEE
Entity type:Individual
Prefix:MS
First Name:LUANN
Middle Name:RENEE
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 1:5110 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44319-3912
Mailing Address - Country:US
Mailing Address - Phone:330-801-3724
Mailing Address - Fax:
Practice Address - Street 1:5110 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44319-3912
Practice Address - Country:US
Practice Address - Phone:330-801-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2472391174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2472391OtherOHIO PROVIDER NUMBER