Healthcare Provider Details

I. General information

NPI: 1578536165
Provider Name (Legal Business Name): ANGELA MARIE MORRIS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 CUMBERLAND FALLS HWY SUITE U-7
CORBIN KY
40701-2743
US

IV. Provider business mailing address

1707 CUMBERLAND FALLS HWY SUITE U-7
CORBIN KY
40701-2743
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-9993
  • Fax: 606-528-5553
Mailing address:
  • Phone: 606-528-9993
  • Fax: 606-528-5553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0380
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0785
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: