Provider Demographics
NPI:1871593020
Name:MORRIS, MELANIE (NP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 E COMMON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3156
Mailing Address - Country:US
Mailing Address - Phone:830-620-1272
Mailing Address - Fax:830-620-1274
Practice Address - Street 1:1626 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3156
Practice Address - Country:US
Practice Address - Phone:830-620-1272
Practice Address - Fax:830-620-1274
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX508613363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89N675OtherBCBS
TX092918464Medicaid
TX83N722Medicare PIN
TX89N675OtherBCBS
TX8A5328Medicare PIN