Basic Information
| Provider Information | |||||||||
| NPI: | 1710111935 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRISON | ||||||||
| FirstName: | CHELSIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 698 E 600 S | ||||||||
| Address2: | |||||||||
| City: | PRESTON | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832631632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084063313 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 S 11TH AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | POCATELLO | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832014835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082326260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2009 | ||||||||
| LastUpdateDate: | 10/16/2014 | ||||||||
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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 | 207Q00000X | O-0675 | ID | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.