MEDICARE: TRESA MORRIS APRN, PMHNP-BC

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN263950	GA
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	815209	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11013791	FL
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	68605	ID
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	40181	NV
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	176194	MT
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN263950	GA

General Provider Information

NPI Number	:	1285285072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRESA MORRIS APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	2274 SALEM RD SE STE 106-1485
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	770-728-9491
Fax Number	:

Provider Business Practice Location Address
First Line	:	2274 SALEM RD SE STE 106-1485
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	770-728-9491
Fax Number	:

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

Provider Enumeration Date	:	09/24/2019
Last Update Date	:	06/04/2024

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