Provider Demographics
NPI:1871148833
Name:MORRIS, JANESSA LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:JANESSA
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JANESSA
Other - Middle Name:LYNN
Other - Last Name:GANTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 OVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:PA
Mailing Address - Zip Code:16059-3624
Mailing Address - Country:US
Mailing Address - Phone:724-316-9740
Mailing Address - Fax:
Practice Address - Street 1:79 WAGNER RD STE 200
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-2338
Practice Address - Country:US
Practice Address - Phone:724-773-1994
Practice Address - Fax:878-439-3593
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty