Provider Demographics
NPI:1669138459
Name:MORRELL, DESIREE D (RN)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:D
Last Name:MORRELL
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 1:289 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4323
Mailing Address - Country:US
Mailing Address - Phone:724-223-7801
Mailing Address - Fax:
Practice Address - Street 1:289 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4323
Practice Address - Country:US
Practice Address - Phone:724-223-7801
Practice Address - Fax:724-223-7802
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN521862L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse