Provider Demographics
NPI:1205163979
Name:MORRIS, LITA M (CNM)
Entity type:Individual
Prefix:
First Name:LITA
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E GENESEE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3130
Mailing Address - Country:US
Mailing Address - Phone:315-426-1100
Mailing Address - Fax:315-426-1153
Practice Address - Street 1:600 E GENESEE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3130
Practice Address - Country:US
Practice Address - Phone:315-426-1100
Practice Address - Fax:315-426-1153
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 10844NM367A00000X
NYF001403367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife