Healthcare Provider Details

I. General information

NPI: 1558168799
Provider Name (Legal Business Name): KODIE MICHELLE MORRIS CNA, HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 SYFRETT RD
COTTONDALE FL
32431-7647
US

IV. Provider business mailing address

2241 SYFRETT RD
COTTONDALE FL
32431-7647
US

V. Phone/Fax

Practice location:
  • Phone: 850-372-2027
  • Fax:
Mailing address:
  • Phone: 850-372-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number342850
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number342850
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number342850
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number342850
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number342850
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number342850
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number342850
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number342850
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number342850
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number342850
License Number StateFL
# 11
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number342850
License Number StateFL
# 12
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number342850
License Number StateFL
# 13
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number342850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: