Healthcare Provider Details

I. General information

NPI: 1588169775
Provider Name (Legal Business Name): ANARKALI ROSE MORRILL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 5210 RAF LAKENHEATH
LAKENHEATH APO
AE 09461
GB

IV. Provider business mailing address

PSC 41 BOX 6933
APO AE
09464-0070
US

V. Phone/Fax

Practice location:
  • Phone: 163-852-8010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02006479A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: