Provider Demographics
NPI:1396158762
Name:MORRIS, NICOLE MICHELLE (AUD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MICHELLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 N CORONADO DR STE B
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-6361
Mailing Address - Country:US
Mailing Address - Phone:520-459-1529
Mailing Address - Fax:
Practice Address - Street 1:1989 S. FRONTAGE RD.
Practice Address - Street 2:AUDIOLOGY HEARING AND BALANCE SERVICES
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85602
Practice Address - Country:US
Practice Address - Phone:520-458-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA#8766231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1396158762Medicaid