Basic Information
| Provider Information | |||||||||
| NPI: | 1558327767 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRISON | ||||||||
| FirstName: | JUNE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 335 PARRISH ST | ||||||||
| Address2: | |||||||||
| City: | CANANDAIGUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144241728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853932888 | ||||||||
| FaxNumber: | 5853969275 | ||||||||
| Practice Location | |||||||||
| Address1: | 335 PARRISH ST | ||||||||
| Address2: | |||||||||
| City: | CANANDAIGUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144241728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853932888 | ||||||||
| FaxNumber: | 5853969275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 11/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | F380268 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | P019380268 | 01 | NY | BLUE CHOICE | OTHER | 02565722 | 05 | NY | MEDICAID | NP0009 | 01 | NY | PREFERRED CARE | OTHER |