Provider Demographics
NPI:1255615662
Name:MORRIS, SUSAN A (RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 SING SING RD
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-1301
Mailing Address - Country:US
Mailing Address - Phone:607-739-6366
Mailing Address - Fax:607-795-2495
Practice Address - Street 1:952 SING SING RD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1301
Practice Address - Country:US
Practice Address - Phone:607-739-6366
Practice Address - Fax:607-795-2495
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY488019-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse