Healthcare Provider Details

I. General information

NPI: 1811725500
Provider Name (Legal Business Name): MALISHA DAWN MORRIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 PILGRIM BLVD
HARTFORD CITY IN
47348-1382
US

IV. Provider business mailing address

410 PILGRIM BLVD
HARTFORD CITY IN
47348-1382
US

V. Phone/Fax

Practice location:
  • Phone: 817-876-9653
  • Fax: 765-348-8335
Mailing address:
  • Phone: 817-876-9653
  • Fax: 765-348-8335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06242018
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: