Healthcare Provider Details

I. General information

NPI: 1831053164
Provider Name (Legal Business Name): KAITLIN MORSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 S COBB DR SE
SMYRNA GA
30080-1359
US

IV. Provider business mailing address

2390 S COBB DR SE
SMYRNA GA
30080-1359
US

V. Phone/Fax

Practice location:
  • Phone: 678-556-0673
  • Fax:
Mailing address:
  • Phone: 678-556-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH035981
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: