Provider Demographics
NPI:1205288222
Name:MORRIS, JERAD EUGENE (RN)
Entity type:Individual
Prefix:MR
First Name:JERAD
Middle Name:EUGENE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:182 COLNER CIR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3576
Mailing Address - Country:US
Mailing Address - Phone:901-674-1252
Mailing Address - Fax:
Practice Address - Street 1:3939 J STREET, SUITE 310
Practice Address - Street 2:SACRAMENTO ANESTHESIA MEDICAL GROUP
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:916-733-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-02
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA834097163W00000X
CA95000578367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse