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General NPI Number Information
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NPI Number | 1659901601
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Entity Type | Individual
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Provider Name | JORDAN MARIE MORRIS PA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 821 BORDEAUX ST
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City | CHADRON
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State | NE
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Zip | 69337-2614
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Country | US
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Telephone | 402-639-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 807 N ASH ST
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City | GORDON
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State | NE
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Zip | 69343-1132
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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