Healthcare Provider Details

I. General information

NPI: 1457534067
Provider Name (Legal Business Name): KARY MCPHERSON MORFORD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 NATCHEZ TRACE DR N
LEXINGTON TN
38351-4144
US

IV. Provider business mailing address

10710 OLD HIGHWAY 64
BOLIVAR TN
38008-3587
US

V. Phone/Fax

Practice location:
  • Phone: 731-967-8803
  • Fax:
Mailing address:
  • Phone: 731-658-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number12456
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: