Basic Information
Provider Information
NPI: 1437776242
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4371 VERONICA S SHOEMAKER BLVD
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339162216
CountryCode: US
TelephoneNumber: 2392748200
FaxNumber: 2392783350
Practice Location
Address1: 8763 RIVER CROSSING BLVD
Address2:  
City: NEW PORT RICHEY
State: FL
PostalCode: 346551112
CountryCode: US
TelephoneNumber: 7278428411
FaxNumber: 7278472923
Other Information
ProviderEnumerationDate: 06/26/2020
LastUpdateDate: 12/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN11007699FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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