Healthcare Provider Details

I. General information

NPI: 1598530610
Provider Name (Legal Business Name): ABRAHAM MORSE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SAYERS DR
WILLIAMSTOWN KY
41097-1216
US

IV. Provider business mailing address

30 SAYERS DR
WILLIAMSTOWN KY
41097-1216
US

V. Phone/Fax

Practice location:
  • Phone: 859-866-5308
  • Fax:
Mailing address:
  • Phone: 859-866-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4011672
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: