Provider Demographics
NPI:1285079079
Name:HENDERSON-MORRIS, DONNA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:HENDERSON-MORRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 OLD JACKSONBORO RD
Mailing Address - Street 2:
Mailing Address - City:RAVENEL
Mailing Address - State:SC
Mailing Address - Zip Code:29470-5201
Mailing Address - Country:US
Mailing Address - Phone:843-889-9411
Mailing Address - Fax:843-889-2205
Practice Address - Street 1:5540 OLD JACKSONBORO RD
Practice Address - Street 2:
Practice Address - City:RAVENEL
Practice Address - State:SC
Practice Address - Zip Code:29470-5201
Practice Address - Country:US
Practice Address - Phone:843-889-9411
Practice Address - Fax:843-889-2205
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR96442163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse