Basic Information
| Provider Information | |||||||||
| NPI: | 1154962272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | CHRYSTLE | ||||||||
| MiddleName: | GAYE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7051 ENVIRON BLVD APT 432 | ||||||||
| Address2: | |||||||||
| City: | LAUDERHILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333194210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542564464 | ||||||||
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| Practice Location | |||||||||
| Address1: | 851 TRAFALGAR CT STE 200E | ||||||||
| Address2: | |||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327517420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3214227166 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2019 | ||||||||
| LastUpdateDate: | 02/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APRN11005965 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163WC0200X | RN9363951 | FL | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.