Provider Demographics
NPI:1215456462
Name:MORSE, JEFFREY THOMAS (BSN, RN)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:THOMAS
Last Name:MORSE
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8328 OAK RIDGE DR
Mailing Address - Street 2:P.O BOX 263
Mailing Address - City:GOODRICH
Mailing Address - State:MI
Mailing Address - Zip Code:48438
Mailing Address - Country:US
Mailing Address - Phone:810-444-9321
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 263
Practice Address - Street 2:
Practice Address - City:GOODRICH
Practice Address - State:MI
Practice Address - Zip Code:48438-0263
Practice Address - Country:US
Practice Address - Phone:810-444-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704216768163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice