Provider Demographics
NPI:1700883436
Name:MORRIS, OLGA M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 N MAIN ST
Mailing Address - Street 2:STE. A
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-3649
Mailing Address - Country:US
Mailing Address - Phone:928-634-7470
Mailing Address - Fax:928-639-3280
Practice Address - Street 1:753 N MAIN ST
Practice Address - Street 2:STE. A
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3649
Practice Address - Country:US
Practice Address - Phone:928-634-7470
Practice Address - Fax:928-639-3280
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ361363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS62432Medicare UPIN
AZ23943Medicare ID - Type Unspecified