Healthcare Provider Details

I. General information

NPI: 1659979169
Provider Name (Legal Business Name): SAMANTHA ROSE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA KASTMAN SAMANTHA KASTMAN

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 CLAYTON RD STE 110
RICHMOND HEIGHTS MO
63117-1850
US

IV. Provider business mailing address

8500 COLLEGE BLVD
OVERLAND PARK KS
66210-1837
US

V. Phone/Fax

Practice location:
  • Phone: 314-900-1112
  • Fax: 888-920-1915
Mailing address:
  • Phone: 913-553-4995
  • Fax: 913-273-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-83104-121
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2020034777
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020034777
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: