Provider Demographics
NPI:1609146471
Name:MORRIS, MYRA ANNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:MYRA
Middle Name:ANNE
Last Name:MORRIS
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MYRA
Other - Middle Name:ANNE
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:62 RIDGEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-4052
Mailing Address - Country:US
Mailing Address - Phone:712-389-5702
Mailing Address - Fax:
Practice Address - Street 1:4409 STONE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-1914
Practice Address - Country:US
Practice Address - Phone:712-389-5702
Practice Address - Fax:253-507-4587
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA149392363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner