Healthcare Provider Details

I. General information

NPI: 1073857173
Provider Name (Legal Business Name): KELLI KRISTINE MORRISON O.T.R./L.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 W LINCOLN ST
LINDSBORG KS
67456-2328
US

IV. Provider business mailing address

11623 ARBOR ST
OMAHA NE
68144-2981
US

V. Phone/Fax

Practice location:
  • Phone: 785-227-3308
  • Fax:
Mailing address:
  • Phone: 785-407-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number130731
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1702568
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: