1538937602 NPI number — SUZANNE JUDITH MORRIS LMT

Table of content: SUZANNE JUDITH MORRIS LMT (NPI 1538937602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538937602 NPI number — SUZANNE JUDITH MORRIS LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS
Provider First Name:
SUZANNE
Provider Middle Name:
JUDITH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORRIS
Provider Other First Name:
SUZANNE
Provider Other Middle Name:
JUDITH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SUZY MORRIS LMT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1538937602
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 KELLER CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTROSE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81401-7441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-310-3750
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1404 HAWK PKWY UNIT 217D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTROSE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81401-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-310-3750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2023

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: 225700000X , with the licence number:  MT.0025744 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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