Provider Demographics
NPI:1306939954
Name:MORRISON, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:505-272-1476
Mailing Address - Fax:
Practice Address - Street 1:4808 MCMAHON BLVD NW
Practice Address - Street 2:UNM FAMILY HEALTH CLINIC WESTSIDE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5010
Practice Address - Country:US
Practice Address - Phone:505-272-2900
Practice Address - Fax:505-772-2909
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2003-0417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E20332Medicare UPIN
AZ846107Medicaid
349412501Medicare Oscar/Certification
NM29373514Medicaid
NM2937351Medicaid