Basic Information
Provider Information
NPI: 1235323445
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: TERRY
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: RN, CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HORTON
OtherFirstName: TERRY
OtherMiddleName: LYNN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6285 BARFIELD RD NE
Address2: SUITE 250
City: ATLANTA
State: GA
PostalCode: 303284303
CountryCode: US
TelephoneNumber: 4043031224
FaxNumber: 4043031325
Practice Location
Address1: 11975 MORRIS RD
Address2: SUITE 200
City: ALPHARETTA
State: GA
PostalCode: 300054419
CountryCode: US
TelephoneNumber: 7707513600
FaxNumber: 7707513615
Other Information
ProviderEnumerationDate: 08/30/2007
LastUpdateDate: 08/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WW0101XRN051226GAY Nursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory

No ID Information.


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