Provider Demographics
NPI:1871588293
Name:MORRISON, VIRGINIA SPRY (CRNP C)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:SPRY
Last Name:MORRISON
Suffix:
Gender:F
Credentials:CRNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 COVE POINT CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18438-6782
Mailing Address - Country:US
Mailing Address - Phone:570-226-2405
Mailing Address - Fax:
Practice Address - Street 1:614 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1821
Practice Address - Country:US
Practice Address - Phone:570-253-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004479B363L00000X, 363LF0000X
PASP008820363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13593JJMMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE