Healthcare Provider Details

I. General information

NPI: 1902957236
Provider Name (Legal Business Name): DENICE ANN MORRISON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 W KANSAS ST SUITE B
LIBERTY MO
64068-2033
US

IV. Provider business mailing address

36850 W 164TH ST
RAYVILLE MO
64084-8119
US

V. Phone/Fax

Practice location:
  • Phone: 816-883-2004
  • Fax: 816-883-2010
Mailing address:
  • Phone: 816-470-7605
  • Fax: 816-883-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number076496
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: