Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 5452 | NV |
N | 208000000X | Pediatrician | 5452 | NV |
NPI | 1285612994 |
---|---|
Provider Name | Colleen Annette Morris |
First Address | Las Vegas, NV 89102-2325 |
Second Address | Las Vegas, NV 89109-2218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 21/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002002570 | (05) | NV |
002019982 | (05) | NV |
BM1609304 | DEA (01) | NV |
CS04870 | STATE PHARMACY (01) | NE |
G42205 | UPIN (01) | NE |