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NPI Code Detail

MEDICARE: MRS. CAROLINE MORRIS PA

MEDICARE:  MRS. CAROLINE  MORRIS  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601006115MI

General Provider Information

NPI Number : 1174804488
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLINE MORRIS PA
Provider Business Mailing Address
First Line : 30508 GEORGETOWN DR
Second Line :
City : BEVERLY HILLS
State : MI
Zip : 48025-4731
Country : US
Telephone Number : 706-296-9286
Fax Number :
Provider Business Practice Location Address
First Line : 30508 GEORGETOWN DR
Second Line :
City : BEVERLY HILLS
State : MI
Zip : 48025-4731
Country : US
Telephone Number : 706-296-9286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2011
Last Update Date : 08/31/2011

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Directions to “ MRS. CAROLINE MORRIS PA” Practice Location

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