Provider Demographics
NPI:1548681059
Name:MORRIS, SUSAN K (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:MORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 LAS TABLAS RD
Mailing Address - Street 2:STE. N
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9732
Mailing Address - Country:US
Mailing Address - Phone:805-434-1825
Mailing Address - Fax:805-434-2761
Practice Address - Street 1:1111 LAS TABLAS RD
Practice Address - Street 2:STE. N
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9732
Practice Address - Country:US
Practice Address - Phone:805-434-1825
Practice Address - Fax:805-434-2761
Is Sole Proprietor?:No
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA5149363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology