Provider Demographics
NPI:1891830469
Name:MORRISON FERNANDEZ, DEANA MAE (DC)
Entity type:Individual
Prefix:DR
First Name:DEANA
Middle Name:MAE
Last Name:MORRISON FERNANDEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DEANA
Other - Middle Name:M
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:620 MAIN STREET
Mailing Address - Street 2:PO BOX 263
Mailing Address - City:WEST MILFORD
Mailing Address - State:WV
Mailing Address - Zip Code:26451-0263
Mailing Address - Country:US
Mailing Address - Phone:304-745-3959
Mailing Address - Fax:304-745-3959
Practice Address - Street 1:620 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:WV
Practice Address - Zip Code:26451-0263
Practice Address - Country:US
Practice Address - Phone:304-745-3959
Practice Address - Fax:304-745-3959
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor