Provider Demographics
NPI:1255920245
Name:GREEN-MORRIS, GLORIA (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:GREEN-MORRIS
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38935-0261
Mailing Address - Country:US
Mailing Address - Phone:662-392-8500
Mailing Address - Fax:
Practice Address - Street 1:87 DORMITORY ROW WEST
Practice Address - Street 2:
Practice Address - City:UNIVERSITY
Practice Address - State:MS
Practice Address - Zip Code:38677-1848
Practice Address - Country:US
Practice Address - Phone:662-915-2195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS860244163W00000X
TX1123014363LP0808X
AZ323954363LP0808X
MS905708363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty