Healthcare Provider Details

I. General information

NPI: 1396158762
Provider Name (Legal Business Name): NICOLE MICHELLE MORRIS AUD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1989 S. FRONTAGE RD. AUDIOLOGY HEARING AND BALANCE SERVICES
SIERRA VISTA AZ
85602
US

IV. Provider business mailing address

157 N CORONADO DR STE B
SIERRA VISTA AZ
85635-6361
US

V. Phone/Fax

Practice location:
  • Phone: 520-458-3383
  • Fax:
Mailing address:
  • Phone: 520-459-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA#8766
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: