Provider Demographics
NPI:1972119469
Name:MORRISON, DEANNA A (RPH)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SANDS PARC BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-0038
Mailing Address - Country:US
Mailing Address - Phone:904-401-4355
Mailing Address - Fax:
Practice Address - Street 1:353 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6275
Practice Address - Country:US
Practice Address - Phone:386-677-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist