Healthcare Provider Details

I. General information

NPI: 1497195010
Provider Name (Legal Business Name): JAMIE KRUTSINGER MORRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC BAMBERG UNIT 27528
APO AE
09139
US

IV. Provider business mailing address

CMR 459 BOX 18707
APO AE
09139-0019
US

V. Phone/Fax

Practice location:
  • Phone: 09513008271
  • Fax:
Mailing address:
  • Phone: 01723984952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN167599
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: