Healthcare Provider Details

I. General information

NPI: 1629045596
Provider Name (Legal Business Name): ANN R MORRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA ANN RISH RN

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 GARRISON AVE
PORT ST JOE FL
32456-5265
US

IV. Provider business mailing address

PO BOX 573
WEWAHITCHKA FL
32465-0573
US

V. Phone/Fax

Practice location:
  • Phone: 850-227-1276
  • Fax: 850-227-1766
Mailing address:
  • Phone: 850-639-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN 2925212
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: