Basic Information
| Provider Information | |||||||||
| NPI: | 1841593654 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRISSEAU | ||||||||
| FirstName: | ANNMARIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 9TH ST N STE 310 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396248250 | ||||||||
| FaxNumber: | 2396248251 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 9TH ST N STE 310 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396248251 | ||||||||
| FaxNumber: | 2396248251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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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 | 363L00000X | ARNP9223187 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 003324300 | 05 | FL | MEDICAID | Y06JW | 01 | FL | BCBS | OTHER | EK662Z | 01 | FL | MEDICARE | OTHER |