Healthcare Provider Details

I. General information

NPI: 1689238453
Provider Name (Legal Business Name): KATHERYN CARMICHAEL MORRIS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERYN MCCALL CARMICHAEL

II. Dates (important events)

Enumeration Date: 04/27/2019
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 E HIGH ST
SPRINGFIELD OH
45505-1225
US

IV. Provider business mailing address

1821 E HIGH ST
SPRINGFIELD OH
45505-1225
US

V. Phone/Fax

Practice location:
  • Phone: 937-323-7340
  • Fax: 937-323-3363
Mailing address:
  • Phone: 937-323-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-159833
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1105885
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCNP.0027375
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: