| Doctor Name: | DIANE MORRIS |
| NPI Number: | 1295991057 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP |
| License Number: | R652067 |
| Business Practice Address: | 910 Second St Prentiss, MS - 394749117 |
| Business Phone Number: | 6017922078 |
| Business Fax Number: | 6017928211 |
| Mailing Address: | Po Box 13445, JACKSON |
| State: | MS |
| Postal Code: | 392363445 |
| Phone Number: | 6018322450 |
| Fax Number: | |
| NPI Enumeration Date: | 07/31/2008 |
| NPI Last Update Date: | 04/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R652067 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |