Provider Demographics
NPI:1811725500
Name:MORRIS, MALISHA DAWN (FNP)
Entity type:Individual
Prefix:
First Name:MALISHA
Middle Name:DAWN
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 1:421 E NORTH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:HARTFORD CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47348-1803
Mailing Address - Country:US
Mailing Address - Phone:817-876-9653
Mailing Address - Fax:
Practice Address - Street 1:421 E NORTH ST UNIT A
Practice Address - Street 2:
Practice Address - City:HARTFORD CITY
Practice Address - State:IN
Practice Address - Zip Code:47348-1803
Practice Address - Country:US
Practice Address - Phone:817-876-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF06242018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily