MEDICARE: REBECCA MORRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.0034863	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.0034863	OH

General Provider Information

NPI Number	:	1013790773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA MORRIS

Provider Business Mailing Address
First Line	:	26863 CARRONADE DR APT 10202
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-6435
Country	:	US
Telephone Number	:	419-410-6865
Fax Number	:

Provider Business Practice Location Address
First Line	:	2213 CHERRY ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2691
Country	:	US
Telephone Number	:	419-251-3232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	10/12/2024

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Directions to “ REBECCA MORRIS ” Practice Location

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