=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114627494
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FELICHA L MORRIS AGPCNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2023
-----------------------------------------------------
Last Update Date | 07/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5800 PARK CENTER CT STE C
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43615-0710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-724-8368
-----------------------------------------------------
Fax | 419-724-8375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4235 SECOR RD
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43623-4299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-473-3561
-----------------------------------------------------
Fax | 419-479-5593
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0033304
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0033304
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------