Healthcare Provider Details

I. General information

NPI: 1154697233
Provider Name (Legal Business Name): JAYNE A. MORRISON A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W TEMPLE AVE STE 205
EFFINGHAM IL
62401-2187
US

IV. Provider business mailing address

1207 NETWORK CENTRE DR STE 3
EFFINGHAM IL
62401-4632
US

V. Phone/Fax

Practice location:
  • Phone: 217-347-0458
  • Fax:
Mailing address:
  • Phone: 217-347-2707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-009444
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: