Individual
DIANE MORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
910 SECOND ST, PRENTISS, MS 39474-9117
(601) 792-2078
(601) 792-8211
Mailing address
PO BOX 13445, JACKSON, MS 39236-3445
(601) 832-2450
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R652067
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00457841
—
MS
Enumeration date
07/31/2008
Last updated
04/13/2012
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