MEDICARE: SAMANTHA ROSE MORRIS

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	363L00000X	Nurse Practitioner	53-83104-121	KS
2	363L00000X	Nurse Practitioner	2020034777	MO
3	363LF0000X	Family Nurse Practitioner	2020034777	MO

General Provider Information

NPI Number	:	1659979169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ROSE MORRIS

Provider Business Mailing Address
First Line	:	8500 COLLEGE BLVD
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-1837
Country	:	US
Telephone Number	:	913-553-4995
Fax Number	:	913-273-3093

Provider Business Practice Location Address
First Line	:	6400 CLAYTON RD STE 110
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1850
Country	:	US
Telephone Number	:	314-900-1112
Fax Number	:	888-920-1915

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

Provider Enumeration Date	:	10/16/2020
Last Update Date	:	05/29/2026

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