1447340971 NPI number — MS. JANICE S MORRISSETTE RN

Table of content: MS. JANICE S MORRISSETTE RN (NPI 1447340971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447340971 NPI number — MS. JANICE S MORRISSETTE RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRISSETTE
Provider First Name:
JANICE
Provider Middle Name:
S
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447340971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7000 AIRPORT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36608-3713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-343-4979
Provider Business Mailing Address Fax Number:
251-343-6013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 AIRPORT BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36608-3713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-343-4979
Provider Business Practice Location Address Fax Number:
251-343-6013
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  156 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 631008104 TRICARE . This is a "DME PROIDER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009964120 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 631008104 ACM . This is a "DME SUPPLIER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 0440974 MEDICAID . This is a "DME PROVIDER" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 510-56006 BCBS . This is a "DME PROVIDER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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