Basic Information
Provider Information
NPI: 1174566004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISON-ROSS
FirstName: PRECIOUS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 CROMWELL BRIDGE RD
Address2: SUITE 200
City: TOWSON
State: MD
PostalCode: 212863300
CountryCode: US
TelephoneNumber: 4108217775
FaxNumber: 4108211320
Practice Location
Address1: 10085 RED RUN BLVD
Address2: SUITE 404
City: OWINGS MILLS
State: MD
PostalCode: 211174836
CountryCode: US
TelephoneNumber: 4108217775
FaxNumber: 4108211320
Other Information
ProviderEnumerationDate: 06/14/2006
LastUpdateDate: 11/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XC0002818MDY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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