Healthcare Provider Details

I. General information

NPI: 1033269980
Provider Name (Legal Business Name): KIMBERLY MARIE MORSE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 KILVERT ST SUITE 310
WARWICK RI
02886-1379
US

IV. Provider business mailing address

9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US

V. Phone/Fax

Practice location:
  • Phone: 781-472-8650
  • Fax:
Mailing address:
  • Phone: 508-222-1019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1773
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: