Provider Demographics
NPI:1093563454
Name:MORRISON, MALINDA (DNAP, CRNA)
Entity type:Individual
Prefix:MRS
First Name:MALINDA
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DNAP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 LISTERMAN RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-6716
Mailing Address - Country:US
Mailing Address - Phone:517-715-9794
Mailing Address - Fax:
Practice Address - Street 1:3475 LISTERMAN RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48855-6716
Practice Address - Country:US
Practice Address - Phone:517-715-9794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304473163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163W00000XNursing Service ProvidersRegistered Nurse