MEDICARE: KRISTI A MORRIS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LC1500X	Community Health Nurse Practitioner	71001867A	IN
2	363LW0102X	Women's Health Nurse Practitioner	71001867A	IN
3	363L00000X	Nurse Practitioner	71001867A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104808005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI A MORRIS NP-C

Provider Business Mailing Address
First Line	:	11109 PARKVIEW PLAZA DR # 117
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 N RANDOLPH ST
Second Line	:
City	:	GARRETT
State	:	IN
Zip	:	46738-1138
Country	:	US
Telephone Number	:	260-357-6557
Fax Number	:	260-357-0373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	05/15/2025

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