Provider Demographics
NPI:1861416067
Name:MORRISON, LINDA THERESA (ACNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:THERESA
Last Name:MORRISON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43900 GARFIELD RD STE 228
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1137
Mailing Address - Country:US
Mailing Address - Phone:586-286-0112
Mailing Address - Fax:269-704-6096
Practice Address - Street 1:43900 GARFIELD RD STE 228
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1137
Practice Address - Country:US
Practice Address - Phone:586-286-0112
Practice Address - Fax:269-704-6096
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704177561363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI114910677Medicaid
MI114910695Medicaid
MI114910686Medicaid
MIP15948Medicare UPIN
MI0P31170007Medicare PIN
MI114910686Medicaid