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General NPI Number Information
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NPI Number | 1275665143
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Entity Type | Organization
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Legal Business Name | SHANDA L J MORRIS MD, PLLC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 1120 MCCANN DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1157
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Country | US
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Telephone | 859-744-0032
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Fax | 859-744-0154
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Provider Business Mailing Address
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Address Line | 1120 MCCANN DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1157
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Country | US
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Telephone | 859-744-0032
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Fax | 859-744-0154
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Authorized Official
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Title or Position | OWNER
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Name | SHANDA L MORRIS
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Credential | MD
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Telephone | 859-744-0032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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