Provider Demographics
NPI:1215691803
Name:MORRISON, AUBREY (MS, MS)
Entity type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 OTWAY BURNS DR
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8494
Mailing Address - Country:US
Mailing Address - Phone:423-653-1277
Mailing Address - Fax:
Practice Address - Street 1:411 WESTERN BLVD STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6822
Practice Address - Country:US
Practice Address - Phone:910-581-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16763225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC16763Medicaid