Provider Demographics
NPI:1740513001
Name:MORROW, MIRIAM (ARNP)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:MORROW
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:GRACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:356 WYATT WAY N.E.
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110
Mailing Address - Country:US
Mailing Address - Phone:206-618-6021
Mailing Address - Fax:
Practice Address - Street 1:356 WYATT WAY N.E.
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110
Practice Address - Country:US
Practice Address - Phone:206-618-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002265363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner