Healthcare Provider Details

I. General information

NPI: 1346940749
Provider Name (Legal Business Name): SARA RACHEL MORRISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 DAMASCUS RD
MARYSVILLE OH
43040-5535
US

IV. Provider business mailing address

12316 BLACK RD
MARYSVILLE OH
43040-8477
US

V. Phone/Fax

Practice location:
  • Phone: 937-578-4040
  • Fax: 937-578-2602
Mailing address:
  • Phone: 614-565-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0032440
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: