Provider Demographics
NPI:1669298022
Name:MORRIS, MICHELLE LYNN (RPH)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1567 NW 101ST ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6713
Mailing Address - Country:US
Mailing Address - Phone:515-249-3571
Mailing Address - Fax:
Practice Address - Street 1:1567 NW 101ST ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6713
Practice Address - Country:US
Practice Address - Phone:515-249-3571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA177811835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric