Provider Demographics
NPI:1649091984
Name:MORRIS, DEONDRA
Entity type:Individual
Prefix:
First Name:DEONDRA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7795 JOE LYNN TRL
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-1236
Mailing Address - Country:US
Mailing Address - Phone:225-326-8280
Mailing Address - Fax:
Practice Address - Street 1:7795 JOE LYNN TRL
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-1236
Practice Address - Country:US
Practice Address - Phone:225-326-8280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle