Healthcare Provider Details

I. General information

NPI: 1194945576
Provider Name (Legal Business Name): TOSHA S MORRIS STNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14163 US HIGHWAY 52
WEST PORTSMOUTH OH
45663-9095
US

IV. Provider business mailing address

14163 US HWY 52
WEST PORTSMOUTH OH
45663
US

V. Phone/Fax

Practice location:
  • Phone: 740-250-2106
  • Fax:
Mailing address:
  • Phone: 740-250-2106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400327060204
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: