Provider Demographics
NPI:1265917694
Name:MORRIS, VALERIE BAUGHN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:BAUGHN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7815
Mailing Address - Country:US
Mailing Address - Phone:662-801-0356
Mailing Address - Fax:
Practice Address - Street 1:156 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5376
Practice Address - Country:US
Practice Address - Phone:601-855-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08350522Medicaid
MM5173187OtherDEA