Provider Demographics
NPI:1356784227
Name:MORRISON, MAXINE JACQUELINE (RN)
Entity type:Individual
Prefix:MS
First Name:MAXINE
Middle Name:JACQUELINE
Last Name:MORRISON
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 1:787 OLD KENSICO RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3109
Mailing Address - Country:US
Mailing Address - Phone:347-465-6109
Mailing Address - Fax:
Practice Address - Street 1:7O VIRGINIA RD
Practice Address - Street 2:14F
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3109
Practice Address - Country:US
Practice Address - Phone:347-465-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4683351163WC0400X, 163WD0400X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health