Provider Demographics
NPI:1316323173
Name:MORRISON, PAMELLA NICOLE (CLPN)
Entity type:Individual
Prefix:MRS
First Name:PAMELLA
Middle Name:NICOLE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:CLPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DESERT CV STE F
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-8001
Mailing Address - Country:US
Mailing Address - Phone:662-687-4288
Mailing Address - Fax:844-270-6261
Practice Address - Street 1:109 DESERT CV STE F
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-8001
Practice Address - Country:US
Practice Address - Phone:662-687-4288
Practice Address - Fax:844-270-6261
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246RP1900X, 372600000X, 3747P1801X
MS334790164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant