Provider Demographics
NPI:1487067195
Name:ELIJAH OSTER-MORRIS, PMHNP-BC, PLLC
Entity type:Organization
Organization Name:ELIJAH OSTER-MORRIS, PMHNP-BC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:OSTER-MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, BC
Authorized Official - Phone:520-977-1582
Mailing Address - Street 1:PO BOX 87653
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85754-7653
Mailing Address - Country:US
Mailing Address - Phone:520-977-1582
Mailing Address - Fax:520-844-1058
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:312
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-977-1582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5553363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty