Healthcare Provider Details

I. General information

NPI: 1144996034
Provider Name (Legal Business Name): CAROL JAN MORRIS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 11/10/2024
Certification Date: 11/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TOWER DR
SUN PRAIRIE WI
53590-1239
US

IV. Provider business mailing address

10 TOWER DR
SUN PRAIRIE WI
53590-1239
US

V. Phone/Fax

Practice location:
  • Phone: 608-825-3500
  • Fax: 608-825-3786
Mailing address:
  • Phone: 608-825-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14558
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: