Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP30005253 | WA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP30005253 | WA |
NPI | 1053401117 |
---|---|
Provider Name | Debra S Morris |
First Address | Poulsbo, WA 98370-6331 |
Second Address | Poulsbo, WA 98370-6331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1001315 | (05) | WA |
9631490 | (05) | WA |
Q11867 | (02) | WA |