Provider Demographics
NPI:1528091295
Name:MORISON, BRENDA SUE (PA-C)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:SUE
Last Name:MORISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E OAK HILL AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4523
Mailing Address - Country:US
Mailing Address - Phone:865-647-3350
Mailing Address - Fax:865-647-3359
Practice Address - Street 1:900 E OAK HILL AVE STE 500
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:865-647-3350
Practice Address - Fax:865-647-3359
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2674363A00000X
TNPA666363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514170Medicaid
TN4304245OtherBCBS TN
TN1514170Medicaid
TN10397I4674Medicare PIN