MEDICARE: TYNEAH MORRIS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0029040	OH
2	163W00000X	Registered Nurse	RN.437886	OH

General Provider Information

NPI Number	:	1184250755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYNEAH MORRIS APRN

Provider Business Mailing Address
First Line	:	3781 W ALEX BELL RD
Second Line	:
City	:	WEST CARROLLTON
State	:	OH
Zip	:	45449-1920
Country	:	US
Telephone Number	:	937-476-1940
Fax Number	:	937-915-0450

Provider Business Practice Location Address
First Line	:	3781 W ALEX BELL RD
Second Line	:
City	:	WEST CARROLLTON
State	:	OH
Zip	:	45449-1920
Country	:	US
Telephone Number	:	937-476-1940
Fax Number	:	937-915-0450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2020
Last Update Date	:	11/05/2025

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