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General NPI Number Information
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NPI Number | 1134567282
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Entity Type | Individual
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Provider Name | TOD MICHAEL MORRISON FNP
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Gender | Male
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 630 E 1400 N STE 150
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City | LOGAN
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State | UT
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Zip | 84341-2549
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Country | US
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Telephone | 435-915-4465
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Fax | 435-799-3664
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Provider Business Mailing Address
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Address Line | 740 S WOODRUFF AVE
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City | IDAHO FALLS
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State | ID
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Zip | 83401-5285
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Country | US
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Telephone | 208-542-9111
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Fax | 208-542-9114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5129925-3102
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License Number State | UT
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