=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427044320
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KENDALL ANNE MORRISON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2005
-----------------------------------------------------
Last Update Date | 08/27/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 TAYLOR AVE SUITE 101
-----------------------------------------------------
City | CROSSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-484-6061
-----------------------------------------------------
Fax | 931-484-6062
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29 TAYLOR AVE SUITE 101
-----------------------------------------------------
City | CROSSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38555-4526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-484-6061
-----------------------------------------------------
Fax | 931-484-6062
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | 37062
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------