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General NPI Number Information
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NPI Number | 1386069284
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Entity Type | Organization
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Legal Business Name | CONNIE MORRIS, CRNP, LLC
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Dates
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Enumeration Date | 02/28/2014
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 13106 WINCHESTER RD SW STE 100
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City | LAVALE
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State | MD
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Zip | 21502-6035
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Country | US
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Telephone | 240-362-7249
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Fax | 240-362-7285
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Provider Business Mailing Address
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Address Line | 13106 WINCHESTER RD SW STE 100
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City | LAVALE
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State | MD
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Zip | 21502-6035
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Country | US
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Telephone | 240-362-7249
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Fax | 240-362-7285
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Authorized Official
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Title or Position | OWNER/FAMILY NURSE PRACTITIONER
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Name | MRS. CONNIE JO MORRIS
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Credential | CRNP
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Telephone | 240-362-7249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | R088399
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License Number State | MD
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