MEDICARE: DOROTHY GRACE MORRISON RN, PNP, PMHNP

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	226306	TX
2	363L00000X	Nurse Practitioner	AP107225	TX
3	363LP0200X	Pediatric Nurse Practitioner	226306	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245239920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY GRACE MORRISON RN, PNP, PMHNP

Provider Business Mailing Address
First Line	:	6560 FANNIN ST STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2726
Country	:	US
Telephone Number	:	713-441-1537
Fax Number	:

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2726
Country	:	US
Telephone Number	:	713-441-1537
Fax Number	:

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	10/03/2018

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