Provider Demographics
NPI:1912650730
Name:MORRIS, KRYSTAL (LVN)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18243 RUSSETT GREEN DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-4130
Mailing Address - Country:US
Mailing Address - Phone:281-865-2092
Mailing Address - Fax:
Practice Address - Street 1:18243 RUSSETT GREEN DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-4130
Practice Address - Country:US
Practice Address - Phone:281-865-2092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205670164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse