Provider Demographics
NPI:1205316288
Name:MORROW, MALLORY DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MALLORY
Middle Name:DAWN
Last Name:MORROW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MALLORY
Other - Middle Name:DAWN
Other - Last Name:DYESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-782-0097
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-761-0566
Practice Address - Fax:806-744-7252
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX827133163WC0200X
TXAP138127363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine