Healthcare Provider Details

I. General information

NPI: 1366907586
Provider Name (Legal Business Name): ASHLEY NICOLE MORRIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2019
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST
BUFFALO NY
14203-1126
US

IV. Provider business mailing address

341 RIVERVIEW DR
YOUNGSTOWN NY
14174-1355
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-7304
  • Fax:
Mailing address:
  • Phone: 716-983-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number308987
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: