Healthcare Provider Details

I. General information

NPI: 1003107574
Provider Name (Legal Business Name): ADAM RICHARD MORRIS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 LANGDON FARM RD APT 4
CINCINNATI OH
45212-1337
US

IV. Provider business mailing address

2875 LANGDON FARM RD. APT #4
CINCINNATI OH
45212
US

V. Phone/Fax

Practice location:
  • Phone: 513-658-2729
  • Fax:
Mailing address:
  • Phone: 513-658-2729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number354186
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number208988
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: