Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 713082 | TX |
NPI | 1003144452 |
---|---|
Provider Name | Elisa Martinez Morrison |
First Address | Gilmer, TX 75644-1738 |
Second Address | Gilmer, TX 75644-1738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2009 |
Last Update Date | 23/11/2009 |