Healthcare Provider Details

I. General information

NPI: 1356311872
Provider Name (Legal Business Name): MARY KAY MORRISON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 RED BUG LAKE RD
WINTER SPRINGS FL
32708-4904
US

IV. Provider business mailing address

966 LAKESIDE DR
APOPKA FL
32712-8113
US

V. Phone/Fax

Practice location:
  • Phone: 407-699-0781
  • Fax:
Mailing address:
  • Phone: 407-886-7727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP1073562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: