Healthcare Provider Details

I. General information

NPI: 1972028124
Provider Name (Legal Business Name): TERRI MARIE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WORCESTER ST STE 1
SPRINGFIELD MA
01151-1056
US

IV. Provider business mailing address

819 WORCESTER ST STE 1
SPRINGFIELD MA
01151-1056
US

V. Phone/Fax

Practice location:
  • Phone: 413-304-2501
  • Fax:
Mailing address:
  • Phone: 413-304-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN265203
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: