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General NPI Number Information
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NPI Number | 1255647988
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Entity Type | Individual
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Provider Name | MICHELLE LYNN MORRIS LPN
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 112 KIMBALL AVE
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City | PENN YAN
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State | NY
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Zip | 14527-1816
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Country | US
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Telephone | 315-536-2752
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Fax | 315-536-4005
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Provider Business Mailing Address
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Address Line | 14 MAIDEN LN PO BOX 423
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City | PENN YAN
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State | NY
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Zip | 14527-1208
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Country | US
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Telephone | 315-531-9102
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Fax | 315-531-9103
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 10 288125
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License Number State | NY
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