Healthcare Provider Details

I. General information

NPI: 1750917563
Provider Name (Legal Business Name): CATHERINE MORRISON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE HENDRICKS RN

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 MAIN ST
JASPER TN
37347-3438
US

IV. Provider business mailing address

4300 MAIN ST
JASPER TN
37347-3438
US

V. Phone/Fax

Practice location:
  • Phone: 423-651-1696
  • Fax: 423-651-1697
Mailing address:
  • Phone: 423-651-1696
  • Fax: 423-651-1697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number252951
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number252951
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30636
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: