Healthcare Provider Details

I. General information

NPI: 1447316856
Provider Name (Legal Business Name): JUDITH ANN MORRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

IV. Provider business mailing address

6 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

V. Phone/Fax

Practice location:
  • Phone: 304-623-5661
  • Fax: 304-623-2180
Mailing address:
  • Phone: 304-623-5661
  • Fax: 304-623-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number28702
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: