Provider Demographics
NPI: | 1275692311 |
---|---|
Name: | MORRISON, LYNN DALE (RN OBGYN NURSE PRACT) |
Entity type: | Individual |
Prefix: | MS |
First Name: | LYNN |
Middle Name: | DALE |
Last Name: | MORRISON |
Suffix: | |
Gender: | F |
Credentials: | RN OBGYN NURSE PRACT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1226 CONSTANT AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PEEKSKILL |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10566 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 914-736-5685 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 107 W 4TH STREET |
Practice Address - Street 2: | MT VERNON NEIGHBORHOOD HEALTH CENTER |
Practice Address - City: | MOUNT VERNON |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10550 |
Practice Address - Country: | US |
Practice Address - Phone: | 914-699-7200 |
Practice Address - Fax: | 914-699-0209 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-12-06 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | F000106 | 363LX0001X |
NY | F000249 | 367A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 363LX0001X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
Not Answered | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |