Provider Demographics
NPI:1770101321
Name:MORRISSEY, DANIEL N (RN)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:N
Last Name:MORRISSEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 TAYLOR RD STE 1313
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-6753
Mailing Address - Country:US
Mailing Address - Phone:386-871-3110
Mailing Address - Fax:
Practice Address - Street 1:980 CANAL VIEW BLVD APT I4
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-4256
Practice Address - Country:US
Practice Address - Phone:386-871-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3488078163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine