Basic Information
| Provider Information | |||||||||
| NPI: | 1659090520 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 QUAIL RUN | ||||||||
| Address2: | |||||||||
| City: | KENNEBUNK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040436996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072299285 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25A JUNE ST STE 111 | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040732642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074907998 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2022 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | CNP221067 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.