Healthcare Provider Details

I. General information

NPI: 1013754761
Provider Name (Legal Business Name): KYLENE MARIA MORSE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 JOHN ROEMMELT DR STE 101
HORSEHEADS NY
14845-8302
US

IV. Provider business mailing address

600 IVY ST STE 206
ELMIRA NY
14905-1627
US

V. Phone/Fax

Practice location:
  • Phone: 607-739-0352
  • Fax: 607-739-6909
Mailing address:
  • Phone: 607-271-2093
  • Fax: 607-271-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354771
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: