Provider Demographics
NPI:1982008132
Name:MORRIS, TED (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 E 118TH ST
Mailing Address - Street 2:SUITE# S1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-9295
Mailing Address - Country:US
Mailing Address - Phone:888-341-6401
Mailing Address - Fax:888-404-1588
Practice Address - Street 1:152 E 118TH ST
Practice Address - Street 2:SUITE# S1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-9295
Practice Address - Country:US
Practice Address - Phone:888-341-6401
Practice Address - Fax:888-404-1588
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2024-07-11
Deactivation Date:2020-10-06
Deactivation Code:
Reactivation Date:2022-02-15
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034174363L00000X, 363L00000X
NY352848363LF0000X, 363LF0000X
CO1685346163W00000X
NC350910163W00000X
OHRN.501822163W00000X
OR10001581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse