Healthcare Provider Details

I. General information

NPI: 1801407564
Provider Name (Legal Business Name): CATHERINE M. VU MORRISSEY MS, RN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE M. VU MS, RN, CPNP-PC

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CENTRE ST
MILTON MA
02186-4118
US

IV. Provider business mailing address

451 CENTRE ST
MILTON MA
02186-4118
US

V. Phone/Fax

Practice location:
  • Phone: 617-827-1155
  • Fax:
Mailing address:
  • Phone: 617-827-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number202018108
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: