Provider Demographics
NPI:1669886743
Name:ROBERTS-MORRIS, MARCIA KATONYA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:KATONYA
Last Name:ROBERTS-MORRIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MARCIA
Other - Middle Name:KATONYA
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ARNP
Mailing Address - Street 1:710 ASH ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-2100
Mailing Address - Country:US
Mailing Address - Phone:850-212-0127
Mailing Address - Fax:
Practice Address - Street 1:710 ASH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-2100
Practice Address - Country:US
Practice Address - Phone:850-212-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9328762163W00000X
GARN219851163W00000X
FL9328762363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse