Healthcare Provider Details

I. General information

NPI: 1306565205
Provider Name (Legal Business Name): ERIN MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7513 COURT STREET
ELIZABETHTOWN NY
12932
US

IV. Provider business mailing address

2155 STATE ROUTE 22B
MORRISONVILLE NY
12962-3417
US

V. Phone/Fax

Practice location:
  • Phone: 518-873-3670
  • Fax: 518-873-3777
Mailing address:
  • Phone: 518-873-3670
  • Fax: 518-563-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number659622-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: