Healthcare Provider Details

I. General information

NPI: 1881550283
Provider Name (Legal Business Name): SAMANTHA RAE MORRIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BEVIER ST
SHELBY MI
49455-1209
US

IV. Provider business mailing address

71 BEVIER ST
SHELBY MI
49455-1209
US

V. Phone/Fax

Practice location:
  • Phone: 231-861-2187
  • Fax:
Mailing address:
  • Phone: 231-215-9176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704346863
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: