Provider Demographics
NPI:1720101728
Name:MORRIS, ROSEMOND (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMOND
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 SHERMAN CHURCH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-3759
Mailing Address - Country:US
Mailing Address - Phone:330-484-2460
Mailing Address - Fax:330-484-2460
Practice Address - Street 1:5920 SHERMAN CHURCH AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-3759
Practice Address - Country:US
Practice Address - Phone:330-484-2460
Practice Address - Fax:330-484-2460
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN045059164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse